Masahiro Satake session 6

Lookback study for transfusion-related HBV infection in Japan: 

Lookback study for transfusion-related HBV infection in Japan Tokyo Metropolitan Red Cross Blood Center Masahiro Satake

Slide2: 

Aliquots from all donations have been stored since 1997. When necessary, each aliquot was investigated using individual donation-NAT (ID-NAT). Subjects for the study : converters for HBs-Ag, HBc-Ab, HCV-Ab, HIV-Ab, screening NAT for HBV, HCV or HIV during April 1999 and February 2005 Lookback study in Japan

Slide3: 

ID-NAT results in repository tubes from seroconverted or NAT-converted donors (‘99 April ~ ’05 February)

No. of HBV ID-NAT positive but pool-NAT negative donors estimated by lookback study: 

No. of HBV ID-NAT positive but pool-NAT negative donors estimated by lookback study These donations do not directly relate to infectivity.

Slide5: 

The infectivity of HBV-ID-NAT positive components No. of ID-NAT positive donation　　　　267 No. of components released 321 　　transfused・・・・・・・・・・・ 　　discarded・・・・・・・・・・・ 　　unknown・・・・・・・・・・・ Outcome of transfused patients（191 reports available ） 　　HBs-Ag conversion 　　HBV-DNA conversion 　　HBs-Ab conversion 　　positive, but no information before transfusion 7 　　markers not changed 　　dead 　　discharged etc. 293 16 12 6 2 3 60 99 14

Slide6: 

HBV infected Undetermined No change others 11 7 60 115 Infectious risk when transfused with ID-NAT positive blood 11／78～18 ／78 The infectivity of HBV-ID NAT-positive components 6～10 HBV infections per year

Slide7: 

Infectivity of HBV ID-NAT positive components Infectivity of W.P. component is 13 times as high as that from chronic carrier.

Implicated components : 

Implicated components

Established cases for HBV infection Disorders of patients: 

Established cases for HBV infection Disorders of patients hematologic malignancy 2 gastric cancer 2 dissecting aortic aneurysm 1 shock due to multiple trauma 1 rheumatoid arthritis 1 unknown 4

ID-NAT in repository tubes --- voluntarily reported HBV cases ---: 

ID-NAT in repository tubes --- voluntarily reported HBV cases ---

Slide11: 

The risk of HBV infection under current screening algorism including 50p-NAT system

Lookback study for HCV and HIV: 

Lookback study for HCV and HIV Seroconversion possibly due to nonspecific reaction was also subjected to lookback study.

Slide13: 

Estimates for the Occurrence of Transfusion-Transmitted Viral Diseases in Japan 　HBV 　　HBV+ donation detectable only by ID-NAT : 1 / 150,000 11～15 infection cases per year 　　 （1 infection / 3.6～5.4 x 105 components） 　HCV　（difficult to estimate） 　　HCV+ donation detectable only by ID-NAT : 1 / 24 million （1 component / 4 years） 　HIV　（difficult to estimate） 　　 HIV+ donation detectable only by ID-NAT : 1 / 12 million （1 component / 2 years）