Possible transmission of variant Creutzfeldt-Jakob disease by blood transfusion
Possible transmission of variant Creutzfeldt-Jakob disease by blood transfusion
复制标题
DOI：
10.1016/s0140-6736(04)15486-x
复制
发表时间：
2004-02-07
期刊：
影响因子：
168.9
通讯作者：
Will, RG
中科院分区：
文献类型：
--
作者：
Llewelyn, CA;Hewitt, PE;Will, RG
背景变异型克雅氏病(VCJD)是由牛海绵状脑病(BSE)病原体感染引起的一种新的人类Prion病。流行病学证据不表明散发性CJD通过输血在人与人之间传播，但这一证据可能不适用于vCJD。我们的目的是确定vCJD是否通过输血传播。方法国家CJD监测单位向英国血液服务机构报告了所有可能或确定的vCJD病例，后者搜索血液中心和医院的献血记录。向监测单位提供了被点名的接受者和捐赠者的信息，以确定接受者或捐赠者与vCJD病例数据库之间是否存在匹配。英国国家统计局也对接受者进行了标记，以确定死亡日期和原因。结果发现，48人被确认从总共15名献血者那里接受了不稳定的血液成分，这些献血者后来成为vCJD病例，并出现在监测单位的登记册上。其中一名受者在接受个人捐赠的红细胞输注6.5年后被确认为vCJD症状。3.5年后，捐赠者出现vCJD症状。解释：我们的发现增加了这种感染通过输血传播的可能性。接受者的感染可能是由于过去饮食中暴露于疯牛病病原体。然而，患者的年龄远远超过大多数vCJD病例，在没有输血传播感染的情况下，在受者身上观察到vCJD病例的机会约为1/15 000至1/30 000。
Background Variant Creutzfeldt-Jakob disease (vCJD) is a novel human prion disease caused by infection with the agent of bovine spongiform encephalopathy (BSE). Epidemiological evidence does not suggest that sporadic CJD is transmitted from person to person via blood transfusion, but this evidence may not apply to vCJD. We aimed to identify whether vCJD is transmissible through blood transfusion.Methods The national CJD surveillance unit reported all cases of probable or definite vCJD to the UK blood services, which searched for donation records at blood centres and hospitals. Information on named recipients and donors was provided to the surveillance unit to establish if any matches existed between recipients or donors and the database of cases of vCJD. Recipients were also flagged at the UK Office of National Statistics to establish date and cause of death.Findings 48 individuals were identified as having received a labile blood component from a total of 15 donors who later became vCJD cases and appeared on the surveillance unit's register. One of these recipients was identified as developing symptoms of vCJD 6.5 years after receiving a transfusion of red cells donated by an individual 3.5 years before the donor developed symptoms of vCJD.Interpretation Our findings raise the possibility that this infection was transfusion transmitted. Infection in the recipient could have been due to past dietary exposure to the BSE agent. However, the age of the patient was well beyond that of most vCJD cases, and the chance of observing a case of vCJD in a recipient in the absence of transfusion transmitted infection is about 1 in 15 000 to 1 in 30 000.