HEPATITIS SCREENING IN THE LITHUANIAN BLOOD ESTABLISHMENTS. Joana Bikulčienė Director of National blood center
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1 HEPATITIS SCREENING IN THE LITHUANIAN BLOOD ESTABLISHMENTS Joana Bikulčienė Director of National blood center
2 Organizational structure of Lithuanian blood service 1 specialized establishment National Blood Center (NBC) agreements with 73 hospitals; activity in 5 cities of Lithuania (affiliates, fixed and mobile sets in Vilnius, Klaipeda, Panevezys, Siauliai, Kaunas). 2 university hospital based blood establishments: the production is used mainly for hospital purposes; the lack is compensated by National Blood Center.
3 Organizational structure of Lithuanian blood service Country population 2,971 mln.
4 Blood donations in Lithuania * National blood center (NBC) VUL Santariskes clinics LSMU Kaunas clinics ,90% 8,20% 70,80% NBC 70,8% VUL Santariskes 20,9% LSMU Kaunas clinics 8,2% *Blood donors register data (available from June 2012)
5 Viral markers testing Each blood donation (at the blood establishment) is mandatory tested for: HIV 1/2 (Ag/anti HIV) Hepatitis B (HBsAg) Hepatitis C (Anti HCV) Syphilis anti TP NAT testing for HIV 1 (HIV RNA), hepatitis B (HBV DNA) and hepatitis C (HVC RNA) (from 2009 mandatory for each serological negative donation)
6 Infectious Marker Screening in National blood center Serology Abbott system ARCHITECT All positive samples must repeated 2 times NAT All serologically negative samples must be tested by NAT Grifols (Novartis) Procleix TIGRIS system (Procleix Ultrio Plus, individual testing and pool from 6) From 2016 we will start work with Roche Cobas 6800 (1/3 individual testing and 2/3 pool from 24)
7 Positive confirmatory testing results for all infections* ,50% 2,00%; 21,70% 21,90%; 56,90% 18,90% 55,00% 21,10%; *Blood donors register data
8 Positive confirmatory testing results NBC (%) ,48 49,44 54,5 56, ,8 21,91 18,48 20, hepatitis C hepatitis B
9 Positive confirmatory testing results 2013* ,5 40 % from all positive results ,4 8,2 0,7 0,9 11,1 0,6 6,3 0 HCV HBV Remunerated first time donations Non remunerated first time donations Remunerated regular donors Non remunerated regular donors
10 Positive confirmatory testing results 2014* ,5 % from all positive results ,6 20 1,8 1 0,6 13,4 5 6,1 0 HCV HBV Remunerated first time donations Non remunerated first time donations Remunerated regular donors Non remunerated regular donors *Blood donors register data
11 Hepatitis C markers rate per donors in first time tested and repeat/regular donors population * ,8 Per donors ,7 2014,9 1938,9 1679, ,7 1254,3 1134, First time donors Regular donors
12 Hepatitis Bmarkers rate per donors in first time tested and repeat/regular donors population * Per donors ,5 1292,4 1219,5 1254, , , ,4 484, ,5 81,3 74,8 28,8 2,8 27,3 33,3 22, first time donors regular donors *Blood donors register data
13 Donations and testing The risk of serological and NAT positive results in remunerated donors* Serological testing Comparing with non remunerated donors Hepatitis B (HBsAg) Hepatitis C (anti HCV) HIV ½ (anti HIV ½) Syphilis (TPHA) 1,54 times higher* 3,11 times higher* not estimated 2,1 times higher* NAT testing (in serological negative donations) Hepatitis B (HBV DNR) Hepatitis C (HCV RNR) HIV 1 (HIV1 DNR) 4,47 7,33 times higher* 22,56 58,33 times higher* not estimated * the difference is statistically significant Sources: National blood center statistics, 2012
14 Main principles of voluntary, non remunerated donations in Lithuania: The main motivation to promote voluntary, non remunerated donation is ensuring the safety of the blood. Person donating blood or blood components not for financial compensation do not have the intention to hide the lifestyle, risk factors and / or health status. (1) State control over blood transfusion service, (2) no private blood establishments, (3) paying more attention and giving financial sources to the program for developing of nonremunerated, voluntary donations. (4) Famous people must show good examples.
15 Non remunerated donations in Lithuania, %* % ,1 34,4 35,4 37,3 30,4 34, , *Blood donors register data
16 Dynamic of remunerated and non remunerated donations in Lithuania* Per 1000 inhabitants ,2 19,4 19,5 18,6 20,6 20,7 20, ,3 16,3 15,6 10 9,2 10,2 10,2 9,6 8,5 9 10,6 6, Remunerated donations Non remunerated donations *Blood donors register data
17 Non remunerated donations in NBC, % ,1 65,5 69,8 69,3 43,5 72,2 82,3 46,2 45,8 74,5 51,6 78,2 77,1 53,8 66, ,8 62, ,5 35,2 36, ,
18 Thank you for your attention
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