Blood Donors in France: Key Figures for 2019–2021
Nearly 3 million blood donations are collected each year in France by approximately 1.6 million donors. To mark World Blood Donor Day, Santé publique France is releasing an update on surveillance data for blood donors in France for the 2019–2021 period. This surveillance allows for the estimation of the prevalence and incidence of blood-borne infections (HIV, HBV, HCV, syphilis) and the risk that a donation may be infected with these pathogens.
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Blood donation, permitted for individuals aged 18 to 70, is governed by ethical principles enshrined in the law of January 4, 1993: anonymity, voluntary participation, informed consent, and non-profit status. The French Blood Establishment and the Armed Forces Blood Transfusion Center are responsible for collecting human blood and its components.
In addition to the systematic screening performed on every unit of blood, the selection of blood donors is a key factor in ensuring the safety of blood products. It aims to protect both the safety of donors (whose health conditions could be exacerbated by donating blood) and the safety of recipients of blood products.
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Blood Donors: Key Monitoring Figures and Results, 2019–2021
Between 2019 and 2021, out of a total of 8.5 million donations collected:
36 tested positive for HIV (a rate of 0.04 per 10,000 donations)
41 tested positive for HTLV (0.05 per 10,000), of which 13 (32%) were detected in the French departments of the Americas (DFA)
178 for HCV (0.21 per 10,000)
350 for HBV (0.41 per 10,000)
899 for syphilis (1.1 per 10,000)
Between 1992–94 and 2019–21, the rates of positive donations all decreased: the HCV rate fell by a factor of 40, the HIV rate by a factor of 11, the HBV rate by a factor of 9, and the HTLV rate by a factor of 4 (since the definition of a positive donation for syphilis was modified in 2007, this trend cannot be calculated).
The decreases observed since 1992 can be attributed to:
stricter screening of blood donors,
improvements in screening tests,
changes in the epidemiology of these infections,
greater awareness among infected individuals of their own status regarding each of these infections, thanks to screening initiatives in the general population.
Epidemiological Surveillance of Blood Donors: The Role of Santé publique France
Since 1993, Santé publique France has coordinated the epidemiological surveillance of blood donors, in partnership with the French Blood Establishment (EFS), the Armed Forces Blood Transfusion Center (CTSA), the National Reference Center for Transfusion-Related Infectious Risks (CNR RIT), and the National Agency for Medicines and Health Products Safety (ANSM). The agency’s missions are defined by Decree No. 2006-99 of February 1, 2006. Under this framework, the data necessary for the epidemiological surveillance of blood donors, collected from each blood transfusion center, must be sent to Santé publique France, which must then transmit the surveillance data to the ANSM as part of the national hemovigilance system.
Changes to blood donor eligibility criteria for men who have sex with men (MSM) effective March 16, 2022
Since March 16, 2022, men who have sex with men have been eligible to donate blood under the same conditions as other donors, meaning they must have had no more than one sexual partner in the past four months.
In light of the favorable context of an extremely low residual HIV risk, the opinion of the High Council of Public Health regarding the conditions necessary for updating selection criteria, and following discussions by the Blood Donor Selection Monitoring Committee, the Ministry of Health has announced the lifting of the 4-month deferral period for men who have sex with men, effective March 16, 2022. This new development regarding access to blood donation for MSM must be accompanied by enhanced monitoring of blood donors in order to provide real-time tracking of indicators that measure the impact of this latest change.
Blood Donation and the Risk of Transmission: What Are the Prevention Measures?
In accordance with regulations, to prevent the risk of transmitting pathogens during blood donation, each donor must complete a pre-donation questionnaire designed to identify any potential contraindications.
If the physician or nurse at the collection site authorizes the donor to donate blood, each donation is then systematically screened for the agents responsible for the following diseases: AIDS, hepatitis B and C, syphilis, and conditions associated with HTLV (HTLV is tested for only in new donors in mainland France and in all donors in the French departments of the Americas).
In addition to these routine screenings, other infections may be tested for if risk factors were identified during the pre-donation interview (e.g., travel, epidemics): malaria, Chagas disease, hepatitis A, toxoplasmosis, dengue, chikungunya, Zika…
Screening tests thus enable the detection of infections in individuals wishing to donate blood. If a pathogen is detected, the donor is then summoned for a post-donation consultation, during which a laboratory test will be performed to confirm the infection and refer the donor to a healthcare professional for treatment. The blood bag will, of course, be destroyed.
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Santé publique France coordinates the epidemiological surveillance of blood donors and helps assess the risk that a blood donation may be infected with a pathogen transmissible through transfusion.
