输血传染病的预防策略

Prevention strategies for transfusion transmitted infectious diseases

经输血传播感染性疾病(transfusion transmitted infectious diseases,TTIDs)是采供血行业面临的血液安全的关键问题。国家通过立法和颁布行业标准指导采供血行业预防TTIDs的发生,主要的预防策略包括通过献血前健康征询和流行病学调查,排除高危人群,从低风险人群中招募献血者;对献血者和血液进行病原体相关标记物检测;利用成分血制备加工技术,减少病原体的数量和活性;监测新发传染病(emerging infectious diseases,EIDs)对血液安全的影响,研判其输血传播的风险及有效的对策。通过严格的献血者选择、血液检测和病原体的灭活等预防策略的实施,在过去三十年里,TTIDs的风险已经大大降低,但检测窗口期、隐匿性感染和质量差错等因素的存在,使TTIDs的残余风险仍然存在。维持健康的固定的献血人群、不断提高检测灵敏度、特异性和血液处理技术的综合使用,仍是不断提高血液安全性的主要策略。

Transfusion transmitted infectious diseases(TTIDs)are a key blood safety concern for the blood collection and supply industry.National legislation and industry standards have guided the blood collection industry in preventing the occurrence of TTIDs.Main prevention strategies include eliminating high-risk groups and recruiting donors from low-risk groups through pre-donation health consultations and epidemiological surveys;testing donors and their blood for pathogen-related markers;using fractionation techniques for blood components to reduce the number and activity of pathogens;and monitoring the impact of emerging infectious diseases(EIDs)on blood safety and identifying the risk of transfusion transmission and its effective countermeasures.The risk of TTIDs has been significantly reduced over the past three decades through the implementation of preventive strategies such as rigorous donor selection,blood screening and inactivation of pathogens,but residual risks of TTIDs remain due to factors such as testing window periods,occult infections,and errors in quality control.Maintaining a healthy and regular blood donor population,continuous improvement in test sensitivity and specificity,and the integrated use of blood processing techniques remain the main strategies to further improve the safety of blood.