The outcome of donor screening for human T-cell lymphotropic virus infection in The Netherlands

Abstract

Background and objectives: Blood donor screening reduces the infectious hazards related to blood transfusion, but the range of agents to be screened for is debatable. In 1993, the screening of all blood donations for Human T-Cell Lymphotropic virus (HTLV) was introduced in The Netherlands. We analysed the outcome and costs of HTLV donor screening.

Methods: For the years 2001-2010, the number of HTLV infections among new and regular donors was used to estimate the prevented number of HTLV-infected donors in the donor pool and the amount of morbidity prevented among recipients.

Results: Human T-Cell Lymphotropic virus screening in The Netherlands detects per year on average 1·4 infected new donors and 0·5 infected regular donors. The prevalence among new donors is 30 times higher than the incidence among regular donors. Without HTLV screening, 14 HTLV-infected donors would be donating blood, causing 0·8 to 0·007 cases of HTLV disease per year.

Conclusion: The lack of accurate estimators for infectivity and pathogenicity hampers the estimation of morbidity and mortality that HTLV-infected transfusions would cause. Leucodepletion may be as effective as HTLV donor screening; its effect on HTLV transmission should be studied.