The Indian Journal of Pediatrics

, Volume 68, Issue 10, pp 951–958 | Cite as

Transfusion transmitted diseases

  • N. Choudhury
  • Sobha Phadke
Special Article


Transfusion transmitted disease (TTD) is a major challenge to the transfusion services all over the world. The problem of TTD is directly proportionate to the prevalence of the infection in the blood donor community. In India, hepatitis B/C, HIV, malaria, syphilis, cytomegalo virus, parvo-virus B-19 and bacterial infections are important causes of concern. Hepatitis B and C infections are prevalent in India and carrier rate is about 1–5% and 1%, respectively. Post transfusion hepatitis B/C is a major problem in India (about 10%) because of low viraemia and mutant strain undetectable by routine ELISA. HIV prevalence among blood donors is different in various parts of the country. It may not be so alarming as projected by some agencies. In one study from north India, confirmed HIV positivity was found in 0.2/1000 blood donor. Post transfusion CMV is difficult to prevent but use of leukocyte filters may help to reduce it significantly. Parvo virus B-19 infection in blood donors is 39.9% which may increase morbidity in multitransfused or immunocompromised patients. Current symphilis tests may not be sensitive but it should be continued to exclude high-risk donors. Malaria is a real problem for India due to the lack of a simple and sensitive screening test. Incidence of bacterial contamination is greatly reduced due to improved collection/ preservation techniques and use of antibiotics in patients. However, proper vigilance and quality control is needed to prevent this problem. Total dependence of altruistic repeat voluntary donors and use of sensitive laboratory tests may help Indian blood transfusion services to reduce incidences of TTDs.

Key words

Hepatitis B virus Hepatitis C virus HIV-I/II CMV 


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  1. 1.
    Menitove JE. How safe is blood transfusion ? In Smith DM, Dodd RY, eds.Transfusion Transmitted Infections. ASCP press, Chicago 1991; 1–22.Google Scholar
  2. 2.
    United States General Accounting Office. Report to the Ranking Minority Member, Committee on Commerce, House of representative. Blood supply, transfusion associated risks.GAO/PEMD 1997; 97–102.Google Scholar
  3. 3.
    Busch MP. HIV, HBV and HCV: new development related to transfusion safety.Vox Sang 2000; 78: 253–256.PubMedCrossRefGoogle Scholar
  4. 4.
    Dodd RY. Transmission of parasites and bacteria by blood components.Vox Sang 2000; 78: 239–242.PubMedGoogle Scholar
  5. 5.
    Randell RL, Holland PV. Transfusion associated hepatitis. In Sarin SK, Hess G, eds.Transfusion Associated Hepatitis: Diagnosis, Treatment and Prevention. CBS Publ. New Delhi. 115–131.Google Scholar
  6. 6.
    Makroo RN, Raina V, Kaushik V. Prevalence of hepatitis C virus antibody in healthy blood donor.Indian J Med Res 1999; 110: 123–125.PubMedGoogle Scholar
  7. 7.
    Tandon BN, Gandhi BM, Joshi YK, Nundy SN, Tandon BN. Etiological spectrum of viral hepatitis and prevalence of markers A and B virus infection in North India.Bull WHO 1984; 84: 508–510.Google Scholar
  8. 8.
    Drugs and Cosmetie Act. The Gazette of India: Extraordinary. Part II, Sec 3(i), dated: 22nd Jan 1993, New Delhi : Publication Division, Government of India.Google Scholar
  9. 9.
    Thyagarajan SP, Jayaram S, Mohanavalli B. Prevalence of hepatitis B in general population of India. In Sarin SK, Singal AL, eds.Hepatitis B in India: Problems and Prevention. CBS Publishers and Distributors, New Delhi, 1996; 5–16.Google Scholar
  10. 10.
    Kant L, Arora SK. Transmission of hepatitis B virus in childhood: Indian Scenario. In Sarin SK, Singal AL, eds.Hepatitis B in India: Problems and Prevention, CBS Publishers and Distributors, New Delhi, 1996; 21–32.Google Scholar
  11. 11.
    Choudhury N, Ramesh V, Saraswat S, Naik S. Effectiveness of mandatory screening tests in Indian blood donors.Indian J Med Res 1995; 64: 541–544.Google Scholar
  12. 12.
    Hoofnagle JH, Seeff LB, Bales ZB, Zimmerman HJ. Veterans Administration Cooperative Study Group. Type B hepatitis after transfusion with blood containing antibody to hepatitis B core antigen.N Eng J Med 1978; 298: 1379–1383.CrossRefGoogle Scholar
  13. 13.
    Amaepurkar DN. Role of surrogate markers in screening for transfusion associated hepatitis. In Sarin SK, Hess G, eds.Transfusion Associated Hepatitis : Diagnosis, Treatment and Prevention. CBS Publ. New Delhi, 149–154.Google Scholar
  14. 14.
    Japanese Red Cross Non-A, Non-B Hepatitis Research Group. Effect of screening for hepatitis C virus antibody and hepatitis B virus core antibody on incidence of post-transfusion hepatitis.Lancet 1991; 338: 1040–1041.CrossRefGoogle Scholar
  15. 15.
    Jongerius JM, Wester M, Cuypers HTM, Van Oostendrop WR, Lelie PN, van der Poel CLet al. New hepatitis B virus mutant form in a blood donor that is undetectable in several hepatitis B surface antigen screening assays.Transfusion 1998; 38: 56–59.PubMedCrossRefGoogle Scholar
  16. 16.
    Nagaraju K, Mishra S, Saraswat S, Choudhury N, Masih B, Ramesh V, Naik S. High prevalence of HBV infectivity in blood donors detected by the dot blot hybridization assay.Vox Sang 1994; 67: 183–186.PubMedCrossRefGoogle Scholar
  17. 17.
    Bodhiphala P, Chaturachumroenchai S, Chiewsilp P, Pruksananonda P. Detection of HBV genome by gene amplification method in HBsAg negative blood donors.J Med Assoc Thai 1999; 82: 491–495.PubMedGoogle Scholar
  18. 18.
    Saraswat S, Benerjee K, Choudhury N, Mahant TC, Khandekar P, Gupta RKet al. Post transfusion hepatitis type B following multiple transfusion of HBsAg negative blood.J Hepatol 1996; 25: 639–643.PubMedCrossRefGoogle Scholar
  19. 19.
    Sarin SK, Saxena R, Sundaram KR. Transfusion associated hepatitis : risks and estimates in Indian population. In Sarin SK, Hess G, eds.Transfusion Associated Hepatitis : Diagnosis, Treatment and Prevention. CBS Publ. New Delhi, 213–220.Google Scholar
  20. 20.
    Holland PV. Post transfusion hepatitis: current risks and causes.Vox Sang 1998; 74 : 135–141.PubMedGoogle Scholar
  21. 21.
    Choo QL, Kuo G, Weiner AJet al. Isplation of a cDNA clone derived from a blood-borne non-A, non-B viral hepatitis genome.Science 1989; 244: 359–361.PubMedCrossRefGoogle Scholar
  22. 22.
    Transfusion of blood and blood components. In Richards G, Bithell TC, Foerster J, Athens JW, Lukens JN, eds.Wintrobe’s Clinical Hematology, Lea & Febiger, 1993; 1: 681–686 I, 1993; 681–686.Google Scholar
  23. 23.
    Ruzzenenti MR, Luigi MC De, Bruni Ret al. PCR testing for HCV in anti HCV negative blood odnors involved in the so called HCV +ve post transfusion hepatitis.Transfn Sci 2000; 22: 161–164.CrossRefGoogle Scholar
  24. 24.
    Schreiber GB, Busch MP, Kleinman SH.N Eng J Med 1996; 1610.Google Scholar
  25. 25.
    Dore GJ, Kaldor JM, McCaughan GW. Systematic review of polymerize chain reaction in defining infectiousness among people infected with hepatitis C virus.BMJ 1997; 315: 333.PubMedGoogle Scholar
  26. 26.
    Menitove JE. Transfusion transmitted disease. In Hoffman R, ed.Hematology : Basic Principles and Practice. Churchill Livingstone 2000, 2310–2320.Google Scholar
  27. 27.
    Choudhury N, Saraswat S, Naveed M. Serological monitoring of thalassaemia major patients for transfusion associated viral infections.Indian J Med Res 1998; 107: 263–268.PubMedGoogle Scholar
  28. 28.
    Bhattacharya DK, Bhattacharya S, De M, Lahiri P. Prevalence of hepatitis C in transfusion dependant thalassaemics and haemophiliacs.Indian J Med Res 1991; 94: 430–432.PubMedGoogle Scholar
  29. 29.
    Ghosh K, Joshi SH, Shetty Set al. Transfusion transmitted diseases in haemophilics from western India.Indian J Med Res 2000; 112: 61–64.PubMedGoogle Scholar
  30. 30.
    Smith DM. Transfusion transmitted human immunodeficiency virus infection. In Smith DM, Dodd RY, eds.Transfusion Transmitted Infections. ASCP Press, Chicago, 1991, p. 73–80.Google Scholar
  31. 31.
    Ward S,W, Bush TJ, Perkins HAet al. National history of transfusion associated infection with human immunodeficiency virus.N Eng J Med 1989; 321: 947–952.CrossRefGoogle Scholar
  32. 32.
    Williams AE, Thomson RA, Schreiber GBet al. Estimates of infectious disease risk factors in US blood donors.JAMA 1997; 227: 967–969.CrossRefGoogle Scholar
  33. 33.
    De M, Bancyee D, Chandra S, Bhattacharya DK. HBV and HIV Seropositivity in multi-transfused in hemophilics and thalasemia in Estern India.Indian J Med Res 1990; 91: 63–63.PubMedGoogle Scholar
  34. 34.
    Ghosh K, Joshi SH, Shetty S, Pawan A, Chipkan S, Pujani Vet al. Transfusion Transmitted diseases in hemophilics from western India.Indian J Med Res 2000; 112: 61–64.PubMedGoogle Scholar
  35. 35.
    Choudhary N, Saraswat S, Naveed M. Serological monitoring of thalasemia major patients for transfusion associated viral infection.Indian J Med Res 1998; 107: 263–268.Google Scholar
  36. 36.
    Chaudhury N, Ayyagiri A, Ray VL. True HTV seroprevalence in Indian blood donors.Transfusion Med 2000; 10: 1–4.CrossRefGoogle Scholar
  37. 37.
    Chattopadhya D, Kiley LW, Kumari S. Behavioral risk factors for acquisition of HIV infection and knowledge about AIDS among male professional blood donor in Delhi.Bull WHO 1991; 69: 319–323.PubMedGoogle Scholar
  38. 38.
    Operational characteristics of commercially available assays to determine antibodies to HIV-1 and/ or HIV-2 in human sera. Report 9/10. World Health Organization, Geneva, 1998, 1–12.Google Scholar
  39. 39.
    Sayers MH, Anderson KC, Goodnaugh LTet al. Reducing the risk for transfusion transmitted cytomegalovirus infection.Ann Intern Med 1992; 116: 55.PubMedGoogle Scholar
  40. 40.
    Zhang LJ, Hanff P, Rutherford Cet al. Detection of human cytomegalovirus DNA, RNA and antibody in normal donor blood.J Infect Dis 1995; 171: 1002.PubMedGoogle Scholar
  41. 41.
    Choudhury N, Naik S, Ramesh V. High frequency of transfusion transmitted viral infection markers in thalassaemia major patients.Ind J Hematol Blood Transf 1995; 13: 115–118.Google Scholar
  42. 42.
    Choudhury N, Naik S, Sharma RK, Elhence P, Rahesh V, Gupta RK. The prevalence of transfusion transmitted diseases in renal transplant recipients.Indian J Pathol Microbiol 1996; 39: 191–195.PubMedGoogle Scholar
  43. 43.
    Dock NL. Post transfusion cytomegalovirus infection. In Smith DM, Dodd RY, eds.Transfusion Transmitted Infections. ASCP Press, Chicago, 1991, 133–146.Google Scholar
  44. 44.
    Hillyer CD, Emmens RK, Zago-Novaretti Met al. Methods for the reduction of transfusion transmitted cytomegalovirus infection: filtration versus the use of seronegative donor units.Transfusion 1994; 34 : 929.PubMedCrossRefGoogle Scholar
  45. 45.
    Kerr JR. Parvovirus B-19 infection.Eur J Clin Microbiol Infect Dis 1996; 15: 10–19.PubMedCrossRefGoogle Scholar
  46. 46.
    Tsujimura M, Matsusita K, Shiraki H, Sato H, Okochi K, Maeda Y. Human parvo virus B-19 infection in blood donors.Vox Sang 1995; 69: 206–212.PubMedGoogle Scholar
  47. 47.
    Pattison JR, Jones SE, Hodgson Jet al. Parvovirus infections and hypoplastic crisis in sickle cell anemia.Lancet 1981; I: 1378.Google Scholar
  48. 48.
    Jordon J, Tiango B, Kiss J, Koch W. Human parvo virus B-19: prevalence of viral DNA in volunteer blood donors and clinical outcomes of transfusion recipients.Vox Sang 1998; 75 : 97–102.Google Scholar
  49. 49.
    Williams MD, Cohen BJ, Bedall AC, Passi KJ, Mortimer PP, Hill FG. Transmission of human parvo virus B-19 by coagulation factor concentrates.Vox Sang 1990; 58: 177–181.PubMedGoogle Scholar
  50. 50.
    Bruce Chwatt LJ. International forum: which are the appropriate modifications of existing regulation designed to prevent the transmission of malaria by transfusion, in view of the increasing frequency of travel to endemic areas ?Vox Sang 1987; 52 : 140–143.Google Scholar
  51. 51.
    Wells L, Ala FA. Malaria and blood transfusion.Lancet 1987; 2: 100–101.Google Scholar
  52. 52.
    Manson Bahr PEC, Apted FIC, eds.Manson’s Tropical Diseases. Bailliere Tindall, London, 1982.Google Scholar
  53. 53.
    Choudhury N, Jolly JG, Mahajan RC, Dubey ML, Kalra A, Gangully NK. Selection of blood donors in malaria endemic countries.Lancet 1988; 2: 972–973.PubMedCrossRefGoogle Scholar
  54. 54.
    Choudhury N, Jolly JG, Mahajan RC, Ganguly NK, Dubey ML, Agnihotri SK. Malaria screening to prevent transmission by transfusion: an evaluation of Techniques.Med Lab Sci 1991; 48 : 206–211.PubMedGoogle Scholar
  55. 55.
    Choudhury N, Jolly JG, Mahajan RC, Dubey ML, Ganguly NK, Agnihotri SK. Donor screening for malaria by antibody and antigen detection in endemic area.Indian J Malarial 1991; 28: 632–634.Google Scholar
  56. 56.
    Branes A. Transfusion transmitted Treponemal infections. In Smith DM, Dodd RY, eds.Transfusion Transmitted Infections. ASCP Press, Chicago, 1991: 161–166.Google Scholar
  57. 57.
    Infectious agents transmitted by transfusion. In Mollison PL, Engelfriet CP, Contreras M, eds.Blood Transfusion in Clinical Medicine. Blackwell Scientific 1997, 546–548.Google Scholar
  58. 58.
    Westphal R. Other organism transmitted by transfusion. In Smith DM, Dodd RY, eds.Transfusion Transmitted Infections. ASCP Press, Chicago, 1991; 180–193.Google Scholar
  59. 59.
    Barbara JAJ, ed.Microbiology in Blood Transfusion. John Bright & Sons Ltd., Bristol, 1983, 104–107.Google Scholar
  60. 60.
    Chandra R, Katiyar JC, Murhty PK, Singh AK, Tiyagi K, Sen AB. Comparison of filarial skin test and microfilaria demonstration in the diagnosis of lymphatic filariasis.Indian J Med Res 1986; 83: 171–174.PubMedGoogle Scholar
  61. 61.
    Wallas CH. Transfusion of blood components contaminated with bacteria. In Smith DM, Dodd RY, eds.Transfusion Transmitted Infections. ASCP Press, Chicago, 1991; 195–206.Google Scholar
  62. 62.
    Stenhouse MAE, Milner LV. Yersinia enterocolitica: a hazard in blood dtransfusion.Transfusion 1982; 22 : 396–398.PubMedCrossRefGoogle Scholar
  63. 63.
    Kosmin M. Bacterimia during leukapheresis.Transfusion 1980; 20: 115.PubMedCrossRefGoogle Scholar
  64. 64.
    Wagner SJ, Friedman LI, Dodd RY. Transfusion associated bacterial sepsis.Clin Microbiol Rev 1994; 7: 290.PubMedGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2001

Authors and Affiliations

  1. 1.Transfusion MedicineSanjay Gandhi Post Graduate Institute of Medical SciencesLucknowIndia
  2. 2.Medical Genetic DeptsSanjay Gandhi Post Graduate Institute of Medical SciencesLucknowIndia

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