Evolving approaches to infectious threats in transfusiology: a systematic literature review

In today's world, issues of infectious safety of blood and its components are becoming increasingly important. Due to significance of this problem, evolving approaches to infectious threats remain central to modernization of transfusion policy and practices. A significant number of publications by Russian and international authors are devoted to the risks associated with transmission of bloodborne pathogens (BBIs) during transfusion of blood and its components. It is well known that, when ensuring infection safety of donor blood, risks may arise related to HIV infection, parenteral viral hepatitis, and emerging infections. Literary data indicate that since the beginning of the 21st century, at least 13 new pathogens have required the attention of blood services, highlighting the need for a proactive approach to transfusion safety aimed at reducing risks associated with transfusion of blood and its components. Prevalence of hepatitis B (HBV) and C (HCV) viruses among the population, as well as the potential donor population, varies in terms of the risk of such individuals becoming part of the donor population. The risk of TTI transmission depends on regional endemicity and varies across individual regions, populations, and donor groups, requiring careful screening and monitoring of pathogens. Microbial evolution and insufficient knowledge of the spectrum of potential pathogens, as well as the limited mandatory donor screening regimen and sensitivity of diagnostic methods, can alter the risk of TTI transmission. Donor selection is a priority for prevention, ensuring the viral safety of blood transfusion media and minimizing the risk of recipient infection. Screening for TTIs to exclude blood donations that pose a risk of transmitting infection to recipients remains a significant component of ensuring safe transfusion. Priority areas of the transfusion safety system should include a set of measures aimed at reducing the risk of infection with bloodborne pathogens at all stages of blood handling: from collection to clinical use.