Pathogen inactivation methods to prevent transfusion-transmissible arboviruses: A systematic review and meta-analysis

Area of Science:

• Transfusion Medicine
• Virology
• Public Health

Background:

• Arboviruses pose a growing risk to transfusion safety.
• Pathogen inactivation methods (PIMs) are crucial for mitigating transfusion-transmitted infections.
• Assessing the efficacy of PIMs against various arboviruses is essential for blood safety.

Approach:

• Systematic literature review and meta-analysis of 59 publications.
• Evaluated main PIMs (amotosalen+UVA, riboflavin+UV, methylene blue+light, solvent detergent, amustaline, PEN110).
• Assessed log reduction factor (LRF) for 17 arboviruses across different blood products.

Key Points:

• For 13 arboviruses, including Dengue and Zika, at least one PIM achieved adequate viral load reduction (LRF ≥4).
• Riboflavin + UV light (Mirasol) demonstrated inferior LRFs overall and for specific blood products.
• Optimal PIMs varied by blood product: solvent/detergent for plasma, THERAFLEX/INTERCEPT for platelets, PEN110 for RBCs/whole blood.

Conclusions:

• PIM efficacy differs significantly across arboviruses and blood products.
• Riboflavin + UV light (Mirasol) is less effective than other PIMs.
• Blood establishments need validated PIMs and logistical readiness for emerging arbovirus threats.