الفهرس 
INTRODUCTION
Infectious threats to blood safetyOnly 14 pages are availabe for public view
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Abstract
Blood transfusion is a life saving intervention that has an essential role in patient management. The provision of safe and efficacious blood and blood components for transfusion involves a number of processes, from the selection of blood donors, collection, processing and testing of blood samples. Thus, while blood transfusion can be life saving, there are associated risks, particularly the transmission of blood borne infections. The hazards of transmitting infection can be minimized by proper screening of donors before collection of blood.
Although WHO stated that screening of all blood donations should be mandatory for; HCV, HBV, HIV and Syphilis, residual infectious risk still remains in blood transfusion. Potential hazardous pathogens may remain undetected either because they are unknown or they are known but not screened such as CMV, EBV, TTV, Parvovirus 19 and others. And also blood donations collected during the serologically silent window period.
Neopterin is a pteridine derivative produced by macrophages activated under the control of gamma- interferon and released from T- cells by the activation of the cellular immune system. In addition to its association with activation of cell mediated immunity and with cell expansion, significant changes were seen in neopterin levels in viral diseases. Its measurement can be used to screen blood donors for presence of viral infections; one of the major goals of this non specific screening strategy is to build a kind of umbrella against virus infections which are not routinely screened.
Ordinary blood transfusion testing can not control for newly emerging and / or recognized infections. Additional non specific screening using immune response markers like neopterin could be a marker for other currently unknown infections or infections not screened and that transmission of these infections may be reduced if they are transmissible by blood transfusion.
The aim of this study was to evaluate serum neopterin levels in hepatitis B, C and / or human immunodeficiency virus infected patients and to compare between the neopterin levels among target patients and healthy blood donors free from these viruses.
This study was carried out during the period from February to August 2010. Samples of infected blood donors were collected randomly over a period of two months to secure 75 virally infected patients either HCV, HBV or HIV and 25 healthy blood donors negative for HBV, HCV and HIV as determined by ELISA technique as a control group. They were asked for age, previous history of HBV, HCV and/ or HIV infection, medical conditions, use of medications, previous operations and last donation time.
Blood samples were collected by venous puncture and divided into two tubes; one empty sterile tube and the other contained EDTA. Samples collected on EDTA were used for determination of absolute lymphocytic count. The samples collected on empty tubes were centrifuged to separate serum and preserved in aliquots at -20° C until tested for the determination of neopterin levels by solid phase enzyme linked immunosorbent assay based on the basic principle of a competitive ELISA.
The main results of the study were
1-Out of 75 infected blood donors, 58 (77%) had elevated neopterin levels and 3 out of 25 control blood donors had elevated neopterin.
2-The mean concentration of neopterin among control group was 5.07 nmol/l and 14.3 nmol/ l among infected blood donors.
3-The mean concentration of neopterin in HIV infected blood donors was 15.8 nmol/l, in HCV was 13.81 nmol/l and in HBV was 14.64 nmol/l.
4-No significant association had been found between neopterin level and other parameters as age, sex and blood group.
from the study it could be concluded that
1-High neopterin levels were detected among most virally infected blood donors.
2-All HIV infected blood donors and most HBV and HCV positive blood donors had high levels of neopterin.
3-There was no significant relation between neopterin levels and sex, age and blood grouping.