Prevalence of human immunodeficiency virus RNA and antibody in first-time, lapsed, and repeat blood donations across five international regions and relative efficacy of alternative screening scenarios.

Details

Serval ID
serval:BIB_CCBF3121C981
Type
Article: article from journal or magazin.
Collection
Publications
Title
Prevalence of human immunodeficiency virus RNA and antibody in first-time, lapsed, and repeat blood donations across five international regions and relative efficacy of alternative screening scenarios.
Journal
Transfusion
Author(s)
Bruhn R., Lelie N., Custer B., Busch M., Kleinman S.
Working group(s)
International NAT Study Group
Contributor(s)
Vermeulen M., Reddy R., Bird A., Cable R., Goubran H., Moftah F., El Ekiaby M., Ghiazza P., Manzini P., Favilli F., Peduzzi C., Roig R., Alvarez M., Sauleda S., Niederhauser C., Levicnik S., Nograsek P., Wessberg S., Elkblom S., Lankinen M., Ulm H., Harritshoj L., Nielsen C., Jorgensen S., Erikstrup C., O'Riordan J., Brojer E., Grabarczyk P., Gdowska J., Piotrowski D., Lam S., Teo D., Chua SS., Lin CK., Tsoi WC., Bon AH., Peng SL., Flanagan P., Brown S., Kiely P., Margaritis A.
ISSN
1537-2995 (Electronic)
ISSN-L
0041-1132
Publication state
Published
Issued date
2013
Volume
53
Number
10 Pt 2
Pages
2399-2412
Language
english
Notes
Publication types: Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't Publication Status: ppublish
Abstract
BACKGROUND: Twenty-one blood organizations from five geographical regions provided HIV individual donation (ID)-NAT and serology data on 11,787,610 donations. Infections were classified as anti-HIV-/RNA+ window period (WP), anti-HIV+/RNA+ concordant positive (CP) or anti-HIV+/RNA- elite controller (EC). Residual risk and efficacy of several screening scenarios were estimated for first time, lapsed and repeat donations.
METHODS: WP residual risk estimates assumed a 50% infectious dose of 3.16 virions and a 50% detection limit of 2.7 HIV RNA copies/mL for ID-NAT and 10,000 copies/mL for p24Ag. Infectivity for CP (100%) and EC (2.2%) donations was estimated based on viral load distributions and 100-fold reduced infectivity by antibody neutralization as reported elsewhere. Efficacy was calculated as proportion of transmission risk removed from baseline (i.e. in absence of any screening).
RESULTS: There was no significant difference in transmission risk between lapsed and repeat donations in any region. Risk was 3.8-fold higher in first time than combined lapsed/repeat donations in South Africa but not in other regions. Screening strategies were most efficacious at interdicting infectious transfusions in first time (98.7-99.8%) followed by lapsed (97.6-99.7%) and repeat (86.8-97.7%) donations in all regions combined. In each donor category the efficacy of ID-NAT alone (97.7-99.8%) was superior to that of minipool (MP)-NAT/anti-HIV (95.0-99.6%) and p24 Ag/anti-HIV (89.8-99.1%).
CONCLUSIONS: Efficacy patterns were similar by donor/donation status in each region despite large differences in HIV prevalence and transmission risk. As similar data become available for HBV and HCV, this modeling may be useful in cost effectiveness analyses of alternative testing scenarios.
Keywords
Antibodies, Viral/blood, Asia/epidemiology, Blood Donors/statistics & numerical data, Blood Transfusion/adverse effects, Blood Transfusion/statistics & numerical data, Europe/epidemiology, Geography, HIV Infections/blood, HIV Infections/diagnosis, HIV Seroprevalence, HIV-1/genetics, HIV-1/immunology, Humans, Mass Screening/methods, Mass Screening/standards, Oceania/epidemiology, RNA, Viral/blood, Serologic Tests/methods, South Africa/epidemiology, Time Factors
Pubmed
Web of science
Create date
09/11/2014 16:54
Last modification date
20/08/2019 16:47
Usage data