Efficacy of HCV core antigen detection during the preseroconversion period.

Trends in residual risk of transfusion-transmitted viral infections in France between 1992 and 2000.

Despite recent advances in blood screening techniques, transfusions are not risk-free procedures. Screening for viral and bacterial infections as well as other newly emerging agents continues to attra

Economics of transfusion

Despite sustained improvement of donor selection and serologic screening assays, there still remains a small but significant transfusion risk for each of the major viral agents (hepatitis B virus [HBV], hepatitis C virus [HCV], human immunodeficiency virus [HIV] and human T-cell leukemia virus [HTLV]). The risk is due to the failure of the screening tests to detect all the infected blood donations and in particular those which are recently infected in the pre-seroconversion window phase of infection, and the asymptomatic immunosilent chronic carriers who never develop antibodies. Another source of risk relates to variant strains of known viruses that are not detected by the current assays. The last potential risk involves the failure to detect infected blood samples because of inaccurate performances of the test process. In order to reduce this residual risk, the French health authorities requested the progressive introduction of nucleic acid technology (NAT) in blood screening so as to be generalised to all blood centres in the course of year 2000. Multicentric studies are underway to identify the most suitable techniques for the French network.

Le dépistage de génomes viraux en transfusion sanguine

RESUME La creation de l’Etablissement francais du sang (EFS) a ete inscrite dans la loi du 1er juillet 1998 relative a la securite sanitaire. L’EFS est un operateur unique de la transfusion sanguine, structure juridique unique, place sous la tutelle du ministre charge de la sante. L’EFS organise sur l’ensemble du territoire les activites de la chaine transfusionnelle, favorise les activites de recherche et participe a la cooperation scientifique internationale. Il peut exercer des activites de biologie medicale et des activites de therapie cellulaire et tissulaire. Dans le cadre du nouveau schema territorial 2000–2004 de la transfusion, l’EFS dispose d’un reseau de 18 etablissements, 14 en metropole, 4 dans les departements d’Outre-Mer (43 dans le precedent schema), qui comprend 18 plateaux techniques de qualification biologique des produits sanguins et 27 de preparation/transformation/stockage. Pour les activites de prelevement et de distribution et dans le respect du principe de proximite vis-a-vis du donneur et du malade, il existe 220 sites sur l’ensemble du territoire. Dans les axes strategiques pour le futur, retenus par l’EFS, il y a la reduction des risques infectieux residuels (apport de la biologie moleculaire), la prevention des risques immunologiques, l’elaboration d’un projet pedagogique pour enseigner autrement la medecine transfusionnelle. Malgre les progres des biotechnologies il faudra attendre encore longtemps pour disposer de produits de substitution a la transfusion sanguine. L’EFS souhaite soutenir 3 poles d’activite: la medecine transfusionnelle, la biologie medicale et l’ingenierie cellulaire. L’EFS avec 18 etablissements et 8 200 personnes doit relever le defi des annees 2000 en s’appuyant sur les progres des biotechnologies.

[Transfusion medicine in the 2000s, on a reform].

Risk–Benefit Analysis of Nucleic Acid Testing: The French Experience

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Risk–Benefit Analysis of Nucleic Acid Testing: The French Experience