Assessing the accuracy of three viral risk models in predicting the outcome of implementing HIV and HCV NAT donor screening in Australia and the implications for future HBV NAT
| Autor: | Anthony J. Keller, T. J. Cobain, Philip Kiely, Clive R. Seed, Anthea Cheng, Bolton Wv, S. Ismay |
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| Rok vydání: | 2002 |
| Předmět: |
Adult
Oncology Hepatitis B virus medicine.medical_specialty HBsAg Immunology Population Blood Donors HIV Infections Hepacivirus medicine.disease_cause Risk Assessment Internal medicine HIV Seropositivity Prevalence medicine Humans Mass Screening Immunology and Allergy Viremia education Screening procedures Probability Retrospective Studies Immunoassay education.field_of_study biology business.industry Australia HIV Transfusion Reaction virus diseases Hematology Models Theoretical Hepatitis B biology.organism_classification Hepatitis C Residual risk Outcome and Process Assessment Health Care Nat Lentivirus RNA Viral Viral disease business |
| Zdroj: | Transfusion. 42:1365-1372 |
| ISSN: | 1537-2995 0041-1132 |
| DOI: | 10.1046/j.1537-2995.2002.00204.x |
| Popis: | BACKGROUND : Risk modeling is now the most practical method of estimating the residual risk of viral transmission in developed countries. One method of assessing the accuracy of a risk model is to measure the observed against the predicted outcome after implementing a new screening method. The primary objective of this paper is to assess the accuracy of three published models in predicting the impact of implementing HIV and HCV NAT in Australia. STUDY DESIGN AND METHODS : Viral screening data on Australian donors for 2000 and 2001 were retrospectively analyzed. The data were applied to the three models to estimate the risk of transmission and predicted NAT yield for HIV, HCV, and HBV. RESULTS : The median risk estimates for the three models were 1 in 3,415,000 for HIV NAT, 1 in 911,000 for HCV NAT, and 1 in 483,000 for HBsAg. The predicted NAT yield for the three models ranged from 0.17 to 0.30 per million donations for HIV, 1.20 to 5.55 for HCV, and 0.47 to 1.01 for HBV. The observed NAT yield was not significantly different from the expected yield with any of the three models for either HIV or HCV. CONCLUSIONS : First, the residual risk in Australian donors is small in comparison with other transfusion complications and comparable to or lower than the risk in US and European nonremunerated donors. Second, mathematical risk modeling has sufficient precision to be used as a predictive tool for risk-benefit assessments of novel screening procedures. Finally, in relation to the case for implementing HBV NAT and/or anti-HBc in Australia, we conclude that at present, there is inadequate information about our donor population to perform an evidence-based risk-benefit analysis. |
| Databáze: | OpenAIRE |
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