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Transfusion - Transmitted Diseases & Infections

You are here : Home/ Blood Bank Zone/ Trasfusion Transmitted Diseases/ 1. Transfusion - Transmitted Diseases & Infections

1. Transfusion - Transmitted Diseases & Infections

Transfusion of blood is not without risks. The most important hazard of blood transfusion is the risk of transmission of blood-borne infections. A knowledge of the infectious agents, with special emphasis on the diseases endemic in a particular region, is essential in understanding the strategies to prevent the transmission of these infections.

Provision of safe blood is of paramount importance and its responsibility lies solely with the blood transfusion service.

Transfusion - Transmitted Infections

The infections transmitted through blood can be divided into :

a. Exogenous

b. Endogenous

Exogenous infections are those which are introduced into a blood unit from an external source.

Endogenous infections are those transmitted from the donor�s blood to the recipient.

The infectious agents known to be transmitted through blood can be

1.	Viruses	-	Cell-associated
		-	Plasma associated
2.	Bacteria
3.	Protozoa

Endogenous microbiological agents transmitted by blood transfusion have certain characteristics and the hallmark is persistence of infection i.e.
* Long incubation period
* Carrier or latent state
* Ability to cause asymptomatic/subclinical infection
* Viability and stability in stored blood or plasma

Viruses transmissible by blood transfusion

Cell associated viruses

* Cytomegalovirus (CMV)
* Epstein-Barr virus (EBV)
* HTLV1*
* HTLV1I*
* Herpes virus (HSV-1 and HSV-2)

Plasma associated viruses

* Hepatitis B virus (HBV)
* Hepatitis Delta virus (HDV)
* Hepatitis A virus (HAV)
* Non-A non-B hepatitis/(one of which is Hepatitis C virus) HCV
* Human immunodeficiency virus (HIV-1 & HIV-2)
* Serum Parvo virus (B-19)

Bacteria and parasites transmissible by blood transfusion

Bacteria
* Treponema pallidum (Syphilis)
* Brucella abortus *
* Yersinia enterocolitica*
* Salmonella
Parasites
* Plasmodium species (Malaria)
* Trypanosoma cruzi (Chagas disease)*
* Toxoplasma gondii (mostly in immunosuppresed patients)
* Leishmania donovani*
* Microfilaria*
* Babesia microfti*
* Infrequently reported in India

Screening tests on donated blood units (Mandatory In India)

* Hepatitis B surface antigen (HBsAg)
* Antibody to HIV-1 & HJV-2
* Antibody to Treponema pallidum (Syphilis)
* Malarial parasite

Other optional test

* Antibody to Hepatitis C virus (Anti HCV)
* Antibody to Cytomegalovirus
* Surrogate tests for Non-A non-B hepatitis
(Hepatitis B core antibody and alanine aminotransferase activity)
* Antibody to Plasmodium falciparum (Malaria)
* Antibody to HTLV-1

Screening tests are usually directed at the antibody to infectious agent rather than antigens for the agent, except in the case of hepatitis B virus. Presence of specific antibody depicts a persistent or chronic infection and therefore indicates a potential for infectivity.

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