Payment for whole blood donations in Lithuania: the risk for infectious disease markers.

BACKGROUND AND OBJECTIVES In Lithuania, remuneration for whole blood donations still prevails, with the government covering payment for the donors. The payment per donation in cash is equal to 40 litas (euro11.6); it is offered to all blood donors and accepted by the majority of them. Donors who gave blood and received the payment are treated as remunerated donors; those who gave blood and did not take the payment are treated as non-remunerated ones. The purpose of this study was to assess the risk of payment for whole blood donations and to analyse the prevalence of infectious diseases markers per 100 remunerated and non-remunerated, first-time and regular whole blood donations, and to compare the risk ratios of infectious disease markers of remunerated and non-remunerated whole blood donations in 2005 and 2006 at the National Blood Center in Lithuania. MATERIALS AND METHODS Whole blood donors were categorized as follows: (i) first-time donor, remunerated; (ii) first-time donor, non-remunerated; (iii) regular donor, remunerated; and (iv) regular donor, non-remunerated. The blood donations were analysed for the presence or absence of the following infectious disease markers: anti-hepatitis C virus (anti-HCV), hepatitis B surface antigen (HBsAg), anti-human immunodeficiency virus (anti-HIV (1)/(2)) and syphilis. Only confirmed infectious disease markers were classified. To assess the risk of payment for whole blood donations, the prevalence of infectious disease markers per 100 donations in the different donor groups and the risk ratios between the remunerated and non-remunerated donations were determined. RESULTS The prevalence per 100 first-time remunerated donations was: for anti-HCV 1.84 (2005) and 2.98 (2006); for HBsAg 1.73 (2005) and 2.03 (2006); for syphilis 0.67 (2005) and 1.03 (2006). The prevalence per 100 first-time non-remunerated donations was: for anti-HCV 0.93 (2005) and 0.98 (2006); for HBsAg 1.57 (2005) and 1.33 (2006); for syphilis 0.29 (2005) and 0.47 (2006). The first-time donors who were remunerated for whole blood donations had a significantly higher prevalence of infectious disease markers per 100 donations and a higher risk ratio for at least three infectious disease markers (HBsAg, anti-HCV and syphilis) as compared to first-time donors who were non-remunerated. The regular donors who were non-remunerated for whole blood donations had the lowest prevalence of all infectious disease markers: anti-HCV -0.03 (2005) and 0.04 (2005); syphilis -0.06 (2005) and 0.02 (2006); and any positive cases of HBsAg and anti-HIV (1)/(2) were found both in 2005 and 2006. No statistically significance differences in incidence and risk ratio existed when comparing the regular donations who were remunerated and non-remunerated. CONCLUSION The payment for whole blood donors provides a higher risk for infectious disease markers of first-time donations at the National Blood Center in Lithuania.