Correlation of ABO/Rh Blood Types with Transfusion-Related Infections in Turkish Donors

Overview

This large-scale retrospective study analyzed 56,766 infected and over 7 million control blood donors in Türkiye from 2015 to 2021, assessing the prevalence of transfusion-transmitted infections (TTIs) and their association with ABO/Rh blood groups. Multivariable logistic regression revealed independent associations between certain blood groups and risks of HBV, HCV, HIV, and syphilis after adjusting for sex, age, and education.

Background

Blood transfusion is essential but carries risks of transfusion-transmitted infections (TTIs) such as HIV, HBV, HCV, and syphilis. The World Health Organization mandates universal screening to reduce these risks. ABO and Rh blood group antigens, expressed on erythrocytes and other tissues, may influence susceptibility to infections, but previous studies have shown conflicting results. In Türkiye, limited and inconsistent data exist on the relationship between ABO/Rh blood groups and TTIs, necessitating robust large-scale studies.

Data Highlights

The study included 56,766 TTI-positive donors and 7,229,867 controls from 2015 to 2021. Donors were categorized by age (18–34 and ≥35 years) and education level (≤8 years vs. ≥9 years). Blood groups were determined using gel centrifuge and microplate techniques. Multivariable logistic regression models adjusted for sex, age group, and education were used to assess associations between ABO/Rh blood groups and individual TTIs (HBV, HCV, HIV, syphilis). False Discovery Rate correction was applied for multiple comparisons.

Key Findings

• HBV, HCV, HIV, and syphilis prevalence trends were characterized among Turkish blood donors from 2015 to 2021.
• Male sex, older age (≥35 years), and lower education (≤8 years) were significant demographic risk factors for TTIs.
• Specific ABO blood groups showed independent associations with increased or decreased risk for individual TTIs after adjusting for confounders.
• Rh (D) antigen status also influenced susceptibility to certain TTIs, though associations varied by infection type.
• Large sample size and standardized nationwide screening protocols enhanced the robustness and generalizability of findings.

Clinical Implications

Understanding the independent associations between ABO/Rh blood groups and TTI risks can aid in refining donor screening strategies and risk assessment. Awareness of demographic risk factors such as age, sex, and education level supports targeted interventions to improve blood safety. These findings underscore the importance of comprehensive screening and donor education to minimize transfusion-related infections.

Conclusion

This comprehensive study demonstrates that ABO and Rh blood group antigens are independently associated with the risk of transfusion-transmitted infections in Turkish blood donors, alongside demographic factors. These insights contribute to improved understanding and management of transfusion safety.

References

1. WHO 2010 -- Blood transfusion safety and essential medicines
2. ISBT 2021 -- Blood group systems and antigens
3. Turkish Ministry of Health 2016 -- National Blood and Blood Components Preparation Guidelines
4. TRC Research Ethics Committee 2022 -- Study approval