DIAGNOSTIC PROCEDURES FOR A GROUP OF DISEASES TRANSMITTED BY BLOOD, WITH SPECIAL REFERENCE TO HIV

U skupinu krvlju prenosivih bolesti ubrajamo infekcije koje predstavljaju jedan od najvećih globalnih opterećenja zdravstvenih sustava. Njihova učestalost i proširenost mjeri se u milijunskim brojkama, a od infekcija od interesa (HIV, HBV, HCV) najveći globalni teret je ipak HBV infekcija. Međutim, HIV infekcija je zbog svojih specifičnih epidemioloških značajki dobila na posebnom značaju u ovom radu. Rizične skupine za spomenute infekcije su: zdravstveni radnici, intravenski korisnici droga, novorođenčad zaraženih trudnica, osobe homoseksualne orijentacije, primatelji organa i transfuzija krvi, ali i ljubitelji ukrašavanja tijela tetovažama i piercing–om. Farmakološka industrija nema razvijenu pre-ekspozicijsku profilaksu za sve navedene infekcije pa se u uvjetima gdje nema podizanja svijesti, kao što su manje razvijene zemlje, infekcije neumoljivo šire. Dijagnostika spomenutih infekcija oslanja se na serološku i molekularnu laboratorijsku dijagnostiku, a razvijena je do zavidnog nivoa. Serološki testovi koje se izvode rutinski su ELISA i IFA testovi, a od molekularnih PCR, TMA i Western blotting. Najveća prednost dijagnostičkih postupaka je razvitak point-of-care testova (POCT), a najveći problem predstavlja fenomen dijagnostičkog prozora (window period). Infections are blood-borne diseases which pose the greatest burden to the health care systems worldwide. Their incidence and prevalence are measured in millions, but what concerns us the most among the infections of interest (HIV, HBV and HCV) is the HBV infection which represents the greatest threat to world’s population. However, due to its specific epidemiological features, HIV infection was discussed in more detail. Risk groups for mentioned infections are: health workers, drug addicts, newborns of infected pregnant women, homosexuals, recipients of organs and blood transfusions as well as tattoos and body piercing fans. Unfortunately, pre-exposure prophylaxis for all these infections has not yet been developed by pharmaceutical industry. Consequently, the infections are spreading relentlessly, especially in less developed parts of the world where the awareness of such diseases is practically nonexistent. Diagnostics of the infections, which has developed to an enviable level, relies on serological and molecular laboratory diagnostics. Serological tests that are performed routinely are ELISA and IFA tests; molecular ones are PCR, TMA and Western blotting. The biggest advantage of diagnostic procedures is the development of point-of-care tests (POCT), while their biggest problem is the phenomenon of the diagnostic window (window period).