Measures to ensure blood safety

14/6/2017

 Following is a question by the Professor Hon Joseph Lee and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (June 14):

Question:

     In order to ensure the supply of safe blood to patients in Hong Kong, the Hong Kong Red Cross Blood Transfusion Service (BTS) carries out tests for infectious diseases, including test for Human Immuno-deficiency Virus (HIV), on each unit of blood collected.  According to the blood donation guidelines of BTS, any person who has a higher risk of being infected with viruses due to certain behaviours (e.g. a man who has had sex with another man) should not give blood.  In this connection, will the Government inform this Council:

(1) of the number of cases in the past 10 years of HIV infections suspected to be caused by blood transfusion; whether BTS had conducted investigations to see if the blood concerned had passed the infectious disease tests and if the blood donors concerned had violated the blood donation guidelines;

(2) whether any mechanism is in place to monitor the compliance with the blood donation guidelines by persons who wish to give blood, so as to ensure blood safety; and

(3) given that some countries (e.g. the United States and New Zealand) allow a man who did not have sex with another man in the past 12 months to give blood, whether it knows if BTS will review its practice of imposing lifetime deferral on that type of persons; if BTS will, of the details; if not, the reasons for that?

Reply:

President,

     The Hong Kong Red Cross Blood Transfusion Service (BTS) provides blood supplies for public and private hospitals in Hong Kong.  It is committed to ensuring blood safety and taking measures to prevent blood recipients from acquiring transfusion-transmitted infection.  My reply to the question raised by the Professor Hon Joseph Lee relating to the measures to ensure blood safety is as follows.

(1) The BTS has not received any local cases of Human Immuno-deficiency Virus (HIV) infection caused by blood transfusion in the past 10 years.

(2) To prevent blood recipients from acquiring transfusion-transmitted infection, all blood donors are required to fill in a health questionnaire each and every time before donation and go through a rigorous screening process.  They are asked to honestly answer the questions in the questionnaire, which cover, inter alia, current and past health status, lifestyle and travel history, so as to help the BTS ensure the safety of the blood collected from the donors.

     In addition, with an automated testing system, the BTS tests all the blood collected for viruses of blood-borne infectious diseases.  The existing test items include HIV antibodies, antigen and ribonucleic acid (RNA), Hepatitis B surface antigen and deoxyribonucleic acid (DNA), Hepatitis C antibodies and RNA, Human T-Lymphotropic Virus antibodies and Syphilis antibodies.  Although the tests conducted by the BTS are up to international standard, there is still limitation in testing technology and hence some diseases cannot be detected during the early stage of infection.  This is commonly referred to as the “window period”.  Therefore, apart from relying on the current tests for infectious diseases, the BTS has to implement stringent measures in screening donors in order to minimise patients’ risks of acquiring transfusion-transmitted infection.  As for HIV test, with advances in technology, the BTS started to conduct Nucleic Acid Testing on the blood samples of all donors in 2007 and the window period for detecting HIV infection in donated blood was then reduced to six days.

      Moreover, the BTS has set up a 24-hour hotline.  Blood donors may contact the medical staff of the BTS if they consider the blood they have donated not suitable for transfusion.  The BTS will take expeditious follow-up actions accordingly.

(3) To ensure blood safety, the BTS conducts health enquiries on donors and implements a blood donor screening policy.  The screening policy was formulated according to the guidelines of the Hospital Authority (BTS) Expert Panel on Blood and Blood Products Safety with a view to ensuring blood safety and blood donors’ health.  The BTS and the expert panel will review from time to time the guidelines on blood donor screening with reference to local and overseas data and guidelines and revise the guidelines where appropriate.

     The BTS has noted that in recent years individual countries, including the United States, Australia, New Zealand, the United Kingdom, Ireland, France, Switzerland and Canada, have amended their screening policies of deferral of blood donation by men who have sex with men (MSM).  It has also noted that some countries or regions have started discussion on amending their policies of permanent deferral of blood donation by MSM.  While its policy guidelines on permanent deferral of blood donation by MSM have been adopted for years, the BTS has kept monitoring local and overseas scientific data, and examining the relationship of changing the deferral period with blood safety.

     Having regard to the views of the expert panel, the BTS is considering the option of relaxing the blood donation policy for MSM by changing the restriction from permanent deferral to one-year deferral.  The BTS has started to discuss the option and exchange views with doctors and patient groups as well as non-profit-making organisations providing support services for patients with AIDS.  The BTS will continue to arrange more meetings and maintain contact with relevant stakeholders to collect views from various sectors before deciding on the way forward.