الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
 |  | from | 179 |  |  |
| | | from | 179 | | |
Abstract
The transmission of infectious diseases through blood sfusion represents a great danger to this effective line Our knowledge of infections which could be trans :.ted through blood transfusion have expanded recently, some worldwide concern while others represent a lem only in localised areas of the world. Hepatitis B is prototype of diseases transmitted through blood trans lion for which testing for hepatitis B surface antigen (one the viral markers) became a universal routine procedure ’blood banks. Testing for hepatitis B surface antigen is, the same time, a preventive measure against delta hepatitis .th is a wo r1 d w i d e d i sea sea f f e c tin g 0 n I y car r i e r s t 0 he p a B virus. No specific test is yet available for non-A, -8 hepatitis which is the leading cause of post-transfusion titis by now. Infectious mononucleosis and mononucleosis e syndrome are diseases which could be transmitted through d transfusion and caused by Epstein-Barr virus and cyto :Blovirus respectively. These represent a danger only to unocompromised persons, for whom a solution is still lacking. hilis is a classic disease known to be transmitted through od transfusion. T est in gb loo d units with either non - t r e ema 1 0 r t rep 0 n e m a 1 t est s i sap rev e n t i ve m ea sur e i n m 0 s t while storing blood units for 3 days in refrigerator is an laternative unreliable measure in deve ing countries. Acquired immunodeficiency syndrome is the danger threatening the blood transfusion service against ch the fastest solution in the human history was developed . testing for antibodies against human immunodeficiency donors from endemic malarious areas for donors with a history of malaria for 3 important preventive measure against transmission transfusion. Chaga’s disease, caused Trypanosoma cruzi, is an endemic disease in Latin America its transmission through blood transfusion is a real pro there. The addition of 125 mg of crystal violet to each t of blood is a successful measure to kill the trypanosomes ’the donated blood. Other diseases which can, on theori tical transmitted through blood transfusion, but are rarely encountered in the service and so no preventive ilU res a g a ins t the m are r e qui red are: he pat i t i sA, toxopla is, African sleeping sickness, bartonellosis and babesiosis. , HTLV-l )human-T-lymphotropic virus-I) is another human was shown to be transmitted through blood and is responsible for adult-T-cell leukemia and myelopathy. Antibody screening of donated blood virus has been licensed in Japan and United States. Human Herpes Virus-6 (HHV-6) and Human-T-Lymphotropic virus !(HTL V-I I) are vir use sin sea r c h 0 f d i sea s e s. H H V - 6 is sus pe c t e d in deterioration of HIV-infected patients,while the causative agent of hairy cell leukaemia. ’ossibility of blood-borne transmission of these viruses is under study. To be able to diagnose each of these diseases, is a great money and practice to any blood bank. In present study, a surrogate test was used in the hope that would cover this extending array of infec tious diseases. Five hundred blood donors were tested for T4/T8 ratio by technique, these donors were recruited from blood bank of Medical Research Institute (MR!) ,Alexandria blood units were traced and only those used of surgery, MRI were followed up. The study 0 included 100 recipients of these units who were patients itted to HR! hospital for elective surgery and planned to ieve only one unit of blood. Recipients were sampled as Haws: Sample No.O:before blood transfusion, 3 monthly samples ter blood transfusions and s,i3.mple No.4, 6-months after blood ’ansfusion. These samples were tested for the following: (evidenced by ALT increase 2.5 times or more above limit of normal), increased ALT (evidenced by increaserl lot reaching 2.5 times the upper limi t of normal), CMV infec (evidenced by anti-CMV seroconversion or four-fold increase ti-CMV titre comparing sample No.3 with sample No.O) and (evidenced by anti-HBc sero-conversion or four~ in anti-HBc titre comparing sample No.4 with sample for anti-HIV was carried out for 200 blood donors ”uding donors to the 100 transfusion recipients being followed anti-HBc was carried out retrospectively for including 35 donors to recipients who showed ,me of hepatitis or increase ALT, as \ell as 25 donors, group to recipients who did not show evidence of increased ALT. The principles of the tests used follows: loglutrate + L.alanine ” L.glutamate + pyruvate ”’ of the concentration of the pyruvate one formed with 2,4 dinitrophenylhvdrazine. lllination of T4/T8 ratio: Lymphocytes are incubated \vith e monoclona1 antibodies to either CD4 epitope (anti-CD4) or itpitope (anti-CD8). A second incubation is performed with an t i -010 use I g G con jug ate d \v it h flu 0 res c i n is 0 t h i 0 c ya n ate FITC) . E v a 1 u a t ion i s car r i e d 0 u t uti 1 i z i n g the u I t r a v i 0 let scope. Lymphocytes having the CD4 epitope (T4) will fluo liith anti-CD4 only, while lymphocytes having the CD8 epi (T8) will fluoresce with anti-CD8 only. ction of anti-HIV: The test is an enzyme immunoassay based sandwitch principle. The \.;ellsof the polystyrene ELISA p8 have been coated with purified HIV, which constitutes the antigen. The test sample is incubated in such a well; -HIV, if present in the sample, will bind to the solid phase gen. Subsequently a conjugate of goat anti-human immuno ulin, which has been labelled with the enzyme horseradish is added. This labelled antibody becomes bound by any antigen/antibody complex previously formed. Incubation substrate produces a yellow orange color in the test ”1. If the sample contains no anti-HIV, then the labelled anti bound and only a low background color develops. titration of anti-CMV:the test is done by EIA bad. Anti-CMV, if present in the sample is bound to the anti on the test plate. The enzyme conjugate reacts with this i~lex. On addition of the substrate solution, a yellowish green is formed through enzymatic cleavage. Un bound reactants are ved by washing procedures. The CMV coated test plates and all necessary reagents used to carry out the test were purchased Be h r i n gIn s tit u t e, G e r m any. and titration of anti-HBc: The test principle is EIA. first reaction step, the antibodies against hepatitis ore antigen (anti-HBc), if present in the sample, are bound to Ag with which the surface of the micro titration plate is ted . Af t e r was h i n g, per 0 x i d a”s e - con jug ate d ant i - H Bc i s b 0 u n din cond reaction to the still free antigenic determinants on the amount of enzyme bound is determined by the addi D of hydrogen peroxide (the enzyme substrate) with the chro en. The enzyme reaction is stopped by the addition of diluted ”huric acid. The color intensity is inversely proportional to concentration of anti-HBc present in the sample. Among the 100 transfusion recipients, there occurred seven s of hepatitis (probable NANB), 28 cases of increased ALT, infections (among those who remained ALT normal single case of HBV infection (in a recipient who rienced ALT increase). All the recipients had CMV antibodies .the pre-transfusion sample. None of the 200 donors tested for HIV reacted positive.