Prevalence, incidence and residual risk of transfusion transmitted viruses (HBV, HCV and HIV infections) in Lithuanian blood donors from 2004 to 2018: The incidence/ window-period model study

Introduction Estimation of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) transfusion risk in blood donors is essential for monitoring the safety of the blood supply and the impact of new screening tests. Due to improvements in donor selection and continuing progress in screening assays, residual risk of virus transmission has significantly decreased over the past years. It is not practical and sometimes even not possible to measure residual risk in blood donors directly and mathematical models are used. The aim of this study was to calculate the prevalence, incidence rates of HBV, HCV and HIV infections and analyse evolution of their transmission residual risk from 2004 to 2018 at the National Blood Center of Lithuania. Materials and methods Data from the archives of the National Blood Center of Lithuania from 2004 to 2018 was retrospectively analysed. The residual risk was calculated for each virus and year by applying the incidence/window-period model suggested by World Health Organization. For the analysis of the residual risk yearly trends a linear regression was used. Results A total of 754,755 blood donors and 1,245,568 donations were included in the analysis and represented a 2.06 donations per donor over 15 years. Average residual risk for HBV, HCV and HIV respectively was 570.04, 807.14 and 35.72 per 1,00,000 donations. During the study period, there was statistically significant downward trend in the residual risk for every analysed virus. Discussion Residual risk of virus transmission has been steadily decreasing over past 15 years in Lithuanian donors, but the current risk remains quite high. It is difficult to establish how much the risk is affected by statistical assumptions or virus prevalence in general population. However, results of this study indicate the need of the population screening program of transfusion transmitted viruses