Comparison of the prevalence of major transfusion-transmitted infections among Iranian blood donors using confidential unit exclusion in an Iranian population

Background: Nucleic acid amplification testing is recommended for screening blood donations; however, they are not widely available in developing countries such as Iranian. Confidential unit exclusion (CUE) gives blood donors the opportunity to confidentially indicate whether their blood is or is not suitable for transfusion to others. Hoewever, its effectiveness in improving blood safety has recently been questioned by the blood banking community. Objectives: The purpose of this study was to determine the efficacy of CUE in Iran. Patients and Methods: Data on transfusion-transmitted disease markers (HBs Ag, HCV Ab, HIV Ab, RPR) were extracted from a database of voluntary blood donations in 2006 at the Tehran Blood Transfusion Center. The prevalence of markers were compared between CUE-positive (“should not use”) and CUE-negative (“can be used”) donations. Results: CUE-positive donations had significantly higher risk of HBV and HCV markers (odds ratio (95% confidence interval): 7.5 (5.4-10.5) and 5.3 (2.5-11.3), respectively). No HIV or syphilis markers were detected in either group. Conclusions: CUE is an effective option for identifying donors with increased risk of HBV and HCV markers.