Screening technologies aimed at identifying such transfusion transmissible infections (TTI) as hepatitis B and C, HIV-1,2 and syphilis have been developing and this has resulted in increased safety of applied hemotherapy. Our research goal was to analyze detection of infectious markers in donors of the FMBA Blood Center over five years. We examined 167,389 samples of donor blood taken from 53,093 donors of blood and its components by the FMBA Blood Center over the period from 2015 to 2019. Over the whole analyzed period, we detected 1453 infectious-positive samples taken from 1235 donors. Average long-term quantity of detected hepatitis C markers equaled 78.6 ± 9.4; hepatitis B, 49.8 ± 8.2; syphilis, 66.2 ± 16.8; HIV, 52.8 ± 13.2. We also analyzed detected of TTI markers in long-term dynamics and established an ascending trend in a number of syphilis markers (the growth rate was 3.2), hepatitis B (the growth rate was 2.5), and a descending trend in hepatitis C markers (the decrease rate was 3.3) as well as HIV markers (the decrease rate was 1.7). This decrease rate in detection of HIV markers (fall by 1.7) occurred both among first-time and regular donors. At the same time, we revealed growing detection of syphilis markers both among first-time donors where it grew by 3.6 and among regular ones, by 1.4. Frequency of infection markers was higher among first-time donors than among regular ones as per syphilis markers, 2.351 (95 % CI: 1.862–2.938), p < 0.00001; hepatitis B markers, 2.111 (95 % CI: 1.622–2.763), p < 0.00001; hepatitis C markers, 2.107 (95 % CI: 1.708–2.609), p < 0.00001; and HIV, 2.471 (95 % CI: 1.9–3.238), p < 0.00001. Over the last 5 years, there was a descending trend in detection of transfusion transmissible infections among donors regarding HIV and viral hepatitis C excluding tests aimed at detecting syphilis and viral hepatitis B markers.

Introduction. The introduction of screening testing for antibodies to the hepatitis B virus nuclear antigen (anti-HBcore) is designed to prevent the procurement of donated blood from individuals with the latent (occult) form of viral hepatitis B, in which surface HBsAg is not identified. Aim – to evaluate the frequency of anti-HBcore markers’ occurrence in donors under the current regulatory and legal framework. Materials and methods. This retrospective observational study was conducted with a follow-up period of one year among blood donors of the Blood Center (BC) of the Federal Medical-Biological Agency. The screening study for anti-HBcore in blood donors and its components was selective in accordance with the requirements of Appendix № 4 of Order № 1166n of October 28, 2020 of the Ministry of Health of Russia. Results. During the study period, the BC was visited by 17,180 donors who donated blood and its components 35,840 times. There were 181 anti-HBcore tests (0.5 % of all blood samples) in 178 unique donors of blood and blood components (1.03 % of all donors). There were 14 positive, 2 questionable and 166 negative results on anti-HBcore tests. The probability of finding a positive result depending on the conditions was 9 % (7.3–14.7 %). There were no statistically significant differences in the detection of anti-HBcore in primary versus regular donors (OR = 2.539; 95% CI: 0.7321–8; p = 0.13), as well as for male donors compared with female donors (OR = 2.448; 95% CI: 0.7141–11.11; p = 0.17). 86.7 % of donors with a positive test for anti-HBcore previously had no signs of viral hepatitis B disease, the presence of questionable HBsAg was not detected, i. e. these cases may be associated with an occult form. Donors who did not previously have questionable results for various bloodborne infections during their donor career had a slightly higher probability of detecting a positive anti-HBcore test compared to donors who previously had these questionable results (OR = 1.24; 95% CI”: 0.42–3.69; p = 0.69). During the period of the donor career, 233 donations of blood and its components were made by donors with a positive result for anti-HBcore, 468 units of donor components were received, of which 365 units were given to medical institutions. Conclusion. The probability of obtaining a positive test for anti-HBcore in the current regulatory environment is random and does not depend on the results of other infectious markers testing. It is recommended to perform anti-HBcore testing with each donation of blood and blood components.

Objective. The aim of the study is to investigate the peculiarities of changes in the immune status of individuals with active and latent forms of herpesvirus infections. Herpesvirus infections are an urgent problem of modern health care. Materials and methods. The prospective longitudinal cohort study included 92 permanent blood donors who were examined twice at 6-month intervals for the presence of specific IgM and IgG antibodies and antigens of herpes simplex viruses 1, 2, Epstein-Barr, cytomegalovirus, human herpesvirus type 6, as well as humoral immunity indicators. Results. In the period from October to April, 68.5 % of blood and its components donors were found to have markers of active herpesvirus infection caused by HSV 1, 2, EBV, CMV, and HHV6. The combination of the detected markers in the absence of clinical manifestations and changes in General and biochemical blood tests indicated asymptomatic reactivation of latent infection. The frequency of reactivations in the autumn and spring months is the same. The absence of IgG production after asymptomatic reactivation of HSV-2 and HHV-6 infections and an increase in IgG concentrations to HSV-1, EBV, and CMV were revealed. EBV infection is the most common among the studied nosologies (98.91 %) and is characterized by statistically significantly higher levels of specific IgG. The effect of asymptomatic reactivation of herpesvirus infections on the levels of total IDA, IgM, IgG, IDE, and CEC was not established. Conclusions. Asymptomatic reactivation of herpesvirus infections does not significantly affect the changes in immune status indicators, and the absence of clinical manifestations, and significant changes in General and biochemical blood tests cause epidemiological risks associated with difficulties in identifying the sources of infection.

Цель. Изучить особенности изменения показателей иммунного статуса лиц с активными и латентными формами герпесвирусных инфекций. Герпесвирусные инфекции представляют актуальную проблему современного здравоохранения. Материалы и методы. В проспективное продольное когортное исследование включено 92 постоянных донора крови, которых обследовали дважды с интервалом 6 месяцев на наличие специфических антител классов IgM и IgG и антигенов вирусов простого герпеса 1, 2, Эпштейна – Барр, цитомегаловируса, вируса герпеса человека 6-го типа, а также показателей гуморального иммунитета. Результаты. В период с октября по апрель у 68,5 % доноров крови и ее компонентов выявлялись маркеры активной герпесвирусной инфекции, вызванной ВПГ1, 2, ВЭБ, ЦМВ, ВГЧ6. Сочетание выявленных маркеров при отсутствии клинических проявлений и изменений в общем и биохимическом анализах крови указывало на бессимптомную реактивацию латентной инфекции. Частота реактиваций в осенние и весенние месяцы одинакова. Выявлено отсутствие выработки IgG после бессимптомной реактивации ВПГ2- и ВГЧ6-инфекциии и увеличение концентрации IgG к ВПГ1, ВЭБ и ЦМВ. ВЭБ-инфекция является самой распространенной среди исследуемых нозологий (98,91 %) и характеризуется статистически достоверно более высокими уровнями специфических IgG. Не установлено влияния бессимптомной реактивации герпесвирусных инфекций на уровни общих IgА, IgM, IgG, IgЕ и ЦИК. Выводы. Бессимптомная реактивация герпесвирусных инфекций не оказывает существенного влияния на изменение показателей иммунного статуса, а отсутствие клинических проявлений и значимых изменений в общем и биохимическом анализах крови обусловливает эпидемиологические риски, связанные со сложностями в выявлении источников инфекции.

A primary task transfusion medicine should solve is to provide infection safety of donor blood and its components. Our research goal was to assess potential risks of a recipient being infected with herpes viruses during transfusion of donor blood and its components and to suggest a set of activities aimed at the risk reduction. We examined blood samples taken from 142 donors who permanently resided in Moscow; our task was to detect markers of active infections caused by herpes simplex viruses, types 1 and 2, Epstein-Barr virus (EBV), cytomegalovirus, and human herpes type 6 virus. Immunoglobulins M and G were determined with ELISA test; antigens, via an indirect immune fluorescence reaction combined with rapid cultural technique. All the donors successfully passed all the selection procedures and were accepted for donation. Active forms were most frequently detected for infections caused by EBV (11.97±2.73 per 100 examined) and human herpes type 6 virus (9.86±2.51 per 100 examined), and it was accordingly 10 and 8.96 times higher than data given by other authors. It indicates there was high epidemic activity of these infectious agents in Moscow city in November-December 2019 and higher risks of recipients being infected with EBV and human herpes type 6 virus with donor blood and its components. Frequency of detecting donors with active infections caused by herpes simples, types 1 and 2, EBV, cytomegalovirus, and human herpes type 6 virus amounted to 27.46±3.76 per 100 examined. Frequency of detecting donors bearing antigens to herpes viruses in their blood amounted to 20.42±3.39 per 100 examined. Risk of potential infecting with examined herpes viruses during blood transfusions amounted to 40.85 per 100 recipients. In order to reduce this risk, we suggest wide implementation of leuko- and pathogen reduction of stored donor blood and its components.