Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Aug;57(8):1998-2006.
doi: 10.1111/trf.14163. Epub 2017 May 28.

What weighs more-low compliance with self-deferral or minor medical procedures? Explaining the high rate of hepatitis C virus window-period donations in Poland

Michal Czerwinski  1 , Piotr Grabarczyk  2 , Malgorzata Stepien  1 , Dorota Kubicka-Russel  2 , Katarzyna Tkaczuk  2 , Ewa Brojer  2 , Magdalena Rosinska  1
Affiliations

What weighs more-low compliance with self-deferral or minor medical procedures? Explaining the high rate of hepatitis C virus window-period donations in Poland

Michal Czerwinski et al. Transfusion. 2017 Aug.

Abstract

Background: Since the introduction of nucleic acid testing (NAT) for routine blood donor screening, hepatitis C virus (HCV) RNA-only detection rates reported from Poland have been higher than in most other European countries.

Study design and methods: To examine factors that likely contribute to these window-period donations, we conducted a case-control study among 47 recently HCV-infected blood donors (cases), who gave blood between July 2002 and June 2014, and 141 controls matched by age, sex, and donation dates. Firth-corrected, conditional logistic regression models were fitted to estimate adjusted odds ratios and 95% confidence intervals. Adjusted population-attributable fractions were calculated based on the distribution of exposure among the cases.

Results: On multivariate analysis, recent exposures in health care environments not routinely ascertained through predonation questionnaires were strongly associated with recently acquired HCV infection. These exposures included minor medical and dental procedures in the preceding 6 months (adjusted odds ratio, 5.77; 95 % confidence interval, 2.01-18.53). However, based on the population-attributable fraction, more important were behavioral deferrable risks that went unreported at the time of donation, such as high-risk sexual behaviors in the preceding 6 months (population-attributable fraction, 34%) or lifetime histories of drug use (population-attributable fraction, 28%).

Conclusions: This study raises questions about the effectiveness of deferral policy in excluding high-risk individuals. In addition, it provides further evidence supporting short, temporal deferrals for small medical procedures and dental treatments in Poland.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1. HCV window period infections (with polynomial trend) among blood donors in Poland, 2002-2014
See this image and copyright information in PMC

References

    1. Stramer SL, Glynn SA, Kleinman SH, et al. National Heart, Lung, and Blood Institute Nucleic Acid Test Study Group. Detection of HIV-1 and HCV infections among antibody-negative blood donors by nucleic acid-amplification testing. N Engl J Med. 2004 Aug 19;351(8):760–8. - PubMed
    1. Kleinman SH, Lelie N, Busch MP. Infectivity of human immunodeficiency virus-1, hepatitis C virus, and hepatitis B virus and risk of transmission by transfusion. Transfusion. 2009;49(11):2454–89. - PubMed
    1. Grabarczyk P. Viral markers screening and transfusion safety. Acta Haematologica Polonica. 2013;44:294–300.
    1. Brojer E, Gronowska A, Medynska J, et al. The HCV genotype frequency in HCV RNA positive/anti-HCV negative blood donors identified in NAT screening program in Poland. Transfusion. 2004;44(12):1706–1710. - PubMed
    1. Busch MP. 10 years of NAT testing – What has been achieved and what needs to be done? Workshop on Surveillance and Screening of Blood Borne Pathogens Zagreb, Croatia. 2010 May; Available: http://www.ipfa.nl/UserFiles/File/WS%202010/14%20-%20Busch%20-%20IPFA%20....

Publication types