Strategies for reducing the risk of transfusion-transmitted leishmaniasis in an area endemic for Leishmania infantum: a patient- and donor-targeted approach
| Autor: | Jimenez-Marco, Teresa, Riera Lizandra, Ma. Cristina, Girona-Llobera, Enrique, Guillen, Carmen, Iniesta González, Laura, Alcover Amengual, Maria Magdalena, Berenguer, Diana, Pujol Brugués, Alba, Tomás Pérez, Míriam, Cancino Faure, María Beatriz, Serra, Teresa, Mascaró, Martín, Gascó, Joan, Fisa Saladrigas, Roser |
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| Přispěvatelé: | Universitat de Barcelona |
| Rok vydání: | 2017 |
| Předmět: | |
| Zdroj: | Dipòsit Digital de la UB Universidad de Barcelona Recercat. Dipósit de la Recerca de Catalunya instname |
| Popis: | Background. In the Balearic Islands, as in other areas of the Mediterranean basin, there is a significant proportion of asymptomatic Leishmania (L.) infantum-infected blood donors, who may represent an important threat to transfusion safety. The Balearic Islands blood bank, located in an area endemic for L. infantum, carried out a study of donors and patients to investigate the impact of this infectious disease on blood safety in the region. Materials and methods. Twenty asymptomatic Leishmania-infected blood donors were followed-up between 2008 and 2011 to investigate the evolution of Leishmania infection in asymptomatic carriers. Their blood was periodically tested for anti-Leishmania antibodies by western blot and for Leishmania DNA by quantitative polymerase chain reaction (qPCR). Additionally, the prevalence of L. infantum infection was investigated in a group of 68 multiply transfused patients to ascertain the risk of transfusion-transmitted leishmaniasis (TTL) in the region, taking into account regular blood component production practices such as pre-storage leucodepletion and pathogen reduction technology. Results. All 20 donors remained asymptomatic over the study period (2008-2011). Most donors had repeatedly positive qPCR results, either persistently or intermittently, but showed no symptoms of Leishmaniasis. Levels of parasitaemia were remarkably low in asymptomatic donors, with values ≤1 parasite/mL. Despite multiple transfusions received over 15 years, no transfused patient studied was infected with L. infantum. Discussion. L. infantum-infected donors can remain asymptomatic for at least 3 years. In our region, no cases of TTL were detected, despite an active search in multiply transfused patients. This seems to be related to two independent variables: (i) a low concentration of the parasite in the peripheral blood of asymptomatic carriers and (ii) the application of methods with proven efficacy against TTL, such as leucodepletion and pathogen reduction technology. |
| Databáze: | OpenAIRE |
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