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Blood Issues

We all know a Thalassemic patient needs blood transfusions every 2-3 weeks, depending on the individual's consumption of the infused cells.

Issues related to the safety and supply of RBCs directly concern thalassemia patients. The blood supply is safer today than it ever has been in the past but still no one can guarantee 100% safety. Thalassemics are continually dependent on blood, hence any new blood-borne pathogen could potentially infect them. Any drop in blood supply could affect the quality of life of the thalassemia patient.

Blood-borne pathogens (Viral Diseases)

HIV (Human Immuno-deficiency Virus) is a blood-borne pathogen and a sexually-transmitted disease. Contamination of the blood supply with HIV peaked from 1978 to 1985. Although it is likely that infections via blood transfusions occurred before 1978, the majority occurred in this 8 year time period. Screening for HIV in the blood supply began in Canada in November 1985. Since that time, some HIV infections via the blood supply have occurred but have been rare since then.

Hepatitis is an inflammation of the liver and can be caused by many factors including viral infection.

Hepatitis B virus is classified as a blood-borne pathogen and also a sexually-transmitted disease. A vaccine for hepatitis B is available and should be given to blood recipients, especially thalassemia patients, prior to transfusion. Currently in Canada, large scale immunization programs for hepatitis B takes place in each province and territory in school-aged children. The blood supply has been tested for hepatitis B. Currently, the risk of getting hepatitis B from a blood transfusion is around 1 in 60,000.

Hepatitis C virus is a blood-borne pathogen. Scientists are still debating whether it can also be considered a sexually-transmitted disease. Currently, it is estimated that sexual transmission of HCV is lower than 10% but there are factors that could increase or lower this risk of transmission.

The primary way to contract hepatitis C virus is from blood to blood contact. The blood supply in Canada has been tested for hepatitis C since November 1990 when an antibody test was first implemented. The risk of transmission of hepatitis C to a blood recipient in Canada is estimated to be 1 in 103,000. In 1999, a more specific test designed to detect the actual virus was implemented in Canada; this test is known as Nucleic Acid Amplification Testing (NAT). With the implementation of NAT for HCV, the risk of transmission is estimated to have dropped to less than 1 in 500,000.

A peak in hepatitis C transmission via the blood supply occurred in the mid to late 1980's. After first-generation testing for hepatitis C began in 1990, the transmission of hepatitis C via the blood supply dropped significantly. Although it is assumed that the majority of cases of post-transfusion hepatitis was caused by hepatitis C, it was not identified until 1990. Prior to its identification, hepatitis C was known as non-A, non-B hepatitis.

Bacterial Infections
Yersinia

Other Pathogens
Hepatitis G
TTV (Transfusion-transmitted Virus)
SEN-V
vCJD