The question whether the use of cytomegalovirus (CMV)-seronegative versus white blood cell (WBC)-reduced blood components is equally efficacious in preventing transfusion-acquired CMV infection remains unresolved. A total of 829 recipients of CMV-seronegative components were followed in 11 studies, and a total of 878 recipients of WBC-reduced components were followed in 12 studies. Twelve (1.45%) of 829 recipients of CMV-seronegative components and 24 (2.73%) of 878 recipients of WBC-reduced components developed CMV infection in these studies. Among bone marrow transplant (BMT) recipients, the risk of CMV infection was, respectively, 1.63% (11/674) and 3.01% (21/697). Four of 7 controlled studies of CMV-seronegative components and 1 of 3 controlled studies of WBC-reduced components indicated benefit from these special components compared with CMV-unscreened/non-WBC-reduced components. One of 3 controlled studies indicated benefit from CMV-seronegative components, as compared with WBC-reduced components. Across a subset of studies whose results were integrated in a meta-analysis, CMV-seronegative or WBC-reduced components were virtually equivalent to each other when they were compared with CMV-unscreened/non-WBC-reduced components. CMV-seronegative components were associated with a 93.1% reduction in the risk of CMV infection; WBC-reduced components were associated with a 92.3% reduction in risk (summary odds ratio [OR] = 0.069; 95% confidence interval [CI], 0.037-0.128; P < .05; and summary OR = 0.077; 95% CI, 0.031-0.190; P < .05, respectively). However, across 3 studies that compared CMV-seronegative and WBC-reduced components to each other, CMV-seronegative components were associated with a 58% reduction in risk (summary OR = 0.42; 95% CI, 0.22-0.79; P < .05). Thus, a meta-analysis of the available controlled studies indicates that CMV-seronegative blood components are more efficacious than WBC-reduced blood components in preventing transfusion-acquired CMV infection.

中文翻译：

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白细胞减少在防止输血传播巨细胞病毒方面是否等同于抗体筛查？文献综述和荟萃分析。

使用巨细胞病毒（CMV）阴性与白细胞（WBC）减少的血液成分是否在预防输血获得性CMV感染方面同样有效的问题仍未解决。在11项研究中，共追踪了829位CMV血清阴性成分的接受者，在12项研究中，共追踪了878位WBC降低成分的接受者。在这些研究中，有829名CMV血清阴性成分的接受者中有十二名（1.45％）和878名WBC减少成分的收件人中有24名（2.73％）发生了CMV感染。在骨髓移植（BMT）接受者中，CMV感染的风险分别为1.63％（11/674）和3.01％（21/697）。CMV血清阴性成分的7项对照研究中的4项和WBC减少的成分的3项对照研究中的1项表明，与CMV未筛选/非WBC减少的成分相比，受益于这些特殊成分。3项对照研究之一表明，与WBC减少的成分相比，CMV血清阴性成分的益处。在将其结果整合到荟萃分析中的一部分研究中，将CMV阴性或WBC减少的成分与未筛选CMV /非WBC减少的成分进行比较，实际上彼此相同。CMV血清阴性成分可使CMV感染风险降低93.1％。白细胞减少的成分与风险降低92.3％相关（总比值比[OR] = 0.069； 95％置信区间[CI]为0.037-0.128； P <.05；汇总OR = 0.077；95％CI，0.031-0.190；P分别为<0.05。但是，在3项将CMV血清阴性成分和WBC降低成分相互比较的研究中，CMV血清阴性成分与降低58％的风险相关（总OR = 0.42； 95％CI，0.22-0.79； P <.05 ）。因此，对现有对照研究的荟萃分析表明，在预防输血获得性CMV感染方面，CMV血清阴性的血液成分比WBC减少的血液成分更有效。