Natural History Studies, a Natural Next Step to Study Emerging Transfusion-Transmitted Infections

Résumé fourni par la source

Bloch et al. [1] reviewed the state of the science of leveraging blood donor populations to study infectious diseases and blood safety.They noted the potential of biorepositories to monitor the safety of the blood supply, for example, the Recipient Epidemiology Donor Study (REDS) of the National Institute for Heart, Lung, and Blood Research (NHLBI) [2].At the National Institutes of Health Clinical Center, we built a large, donor-focused biorepository, Transfusion-Related Infections Prospectively Studied (TRIPS) (2001-present) to 1) follow, intensively, recipients of allogeneic blood transfusion, to obtain sufficient preand post-transfusion samples to insure molecular and/or serologic detection of transfusiontransmitted infectious agents, 2) collect samples of all donations linked to these recipients, and 3) establish a repository so that samples can be rapidly recalled to test for newly emerging pathogens.We enrolled blood donors and prospectively followed blood recipients in order to: 1) establish ongoing surveillance of the incidence of breakthrough infections from transfusion-transmitted agents for which there were existing donor-screening assays (e.g.HBV, HCV, HIV, human T cell lymphotropic virus (HTLV)); 2) monitor the transfusion risk of established infectious agents that were not routinely screened in blood donors including CMV, EBV, parvovirus B-19, HHV-8 [Kaposi's sarcoma virus], and possible hepatitis agents; 3) establish a repository of linked donor and recipient samples so that any newly emerging infectious agent can be rapidly evaluated for its threat to the blood supply.After initial infectious disease testing, recipient samples and linked donor samples were stored in a repository to allow for the assessment of transfusion risk for emerging pathogens and known agents for which there is no practical assay currently available.Preliminary results suggest a low risk of transfusion of the agents studied [3].This study design, a landmark in TTI research, has numerous strengths.The patient population at NIH, Children's National Medical Center, and Suburban Hospital (a community hospital partner with critical care services) offers unique features beneficial and detrimental to study design and logistics.Many of these patients received repeat ✩ The findings and conclusions of this report are those of the authors and do not necessarily represent the official position of the National Institutes of Health.

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