Human immunodeficiency virus prevalence, incidence, and residual risk of transmission by transfusions at Retrovirus Epidemiology Donor Study-II blood centers in Brazil

Autor: Moussa Sarr, João Eduardo Ferreira, Anna Bárbara F. Carneiro-Proietti, David Wright, Divaldo Sampaio, Thelma T. Gonçalez, Ester Cerdeira Sabino, Brian Custer, Nanci A. Salles, Michael P. Busch
Rok vydání: 2011
Předmět:
Zdroj: Transfusion. 52:870-879
ISSN: 0041-1132
Popis: BACKGROUND: In Brazil nationally representative donor data are limited on human immunodeficiency virus (HIV) prevalence incidence and residual transfusion risk. The objective of this study was to analyze HIV data obtained over 24 months by the Retrovirus Epidemiology Donor Study-II program in Brazil. STUDY DESIGN AND METHODS: Donations reactive to third- and fourth-generation immunoassays (IAs) were further confirmed by a less-sensitive (LS) IA algorithm and Western blot (WB). Incidence was calculated for first-time (FT) donors using the LS-EIA results and for repeat donors with a model developed to include all donors with a previous negative donation. Residual risk was projected by multiplying composite FT and repeat donor incidence rates by HIV marker-negative infectious window periods. RESULTS: HIV prevalence among FT donors was 92.2/10(5) donations. FT and repeat donor and composite incidences were 38.5 (95% confidence interval [CI] 25.6-51.4) 22.5 (95% CI 17.6-28.0) and 27.5 (95% CI 22.0-33.0) per 100000 person-years respectively. Male and community donors had higher prevalence and incidence rates than female and replacement donors. The estimated residual risk of HIV transfusion transmission was 11.3 per 10(6) donations (95% CI 8.4-14.2) which could be reduced to 4.2 per 10(6) donations (95% CI 3.2-5.2) by use of individual-donation nucleic acid testing (NAT). CONCLUSION: The incidence and residual transfusion risk of HIV infection are relatively high in Brazil. Implementation of NAT will not be sufficient to decrease transmission rates to levels seen in the United States or Europe; therefore other measures focused on decreasing donations by at-risk individuals are also necessary. (c) 2011 American Association of Blood Banks.
Databáze: OpenAIRE
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