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  • 1
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    An analysis of risk factors for human immunodeficiency virus infection among C hinese blood donors
    Wiley ; 2013
    In:  Transfusion Vol. 53, No. 10pt2 ( 2013-10), p. 2431-2440
    Details
    In: Transfusion, Wiley, Vol. 53, No. 10pt2 ( 2013-10), p. 2431-2440
    Abstract: Information regarding the risk factors for human immunodeficiency virus ( HIV ) infection among C hinese donors is important for understanding the trend of HIV transmission routes and for developing effective donor behavioral screening policies. Study Design and Methods In 2009 to 2011, a total of 77 HIV ‐positive and 649 HIV ‐negative consented donors who screened nonreactive for hepatitis  B virus, hepatitis  C virus, syphilis, and alanine aminotransferase in four R etrovirus E pidemiology D onor S tudy‐ II C hinese regions received and completed a questionnaire by mail regarding their recent and past medical procedures, drug use, and sexual behaviors, etc. Exploratory and confirmatory factor analyses grouped questions into three risk factors. Multivariable logistic regression analysis examined the relationship between risk factors and HIV status adjusting for center, age, sex, and education. Results The three risk factors were test‐seeking tendency, medical‐related risks, and behavioral risks. In multivariable logistic regression analysis, greater test‐seeking tendency and behavioral risks were associated with HIV infection, with the adjusted odds ratios ( OR s) being 2.2 (95% confidence interval [ CI ], 1.2‐4.1) and 3.8 (95% CI , 1.8‐7.9), respectively, but medical risks were not ( OR , 1.2; 95% CI , 0.6‐2.2). In comparison to less high school education, high school and more education was associated with lower risks for HIV infection, with the OR s being 0.35 (95% CI , 0.17‐0.70) and 0.17 (95% CI , 0.09‐0.33), respectively. Conclusions Test‐seeking tendency and high‐risk sexual behaviors are important predictors of HIV infection in C hinese blood donors, suggesting that the health history inquiry used in donor selection process needs improvement to defer high‐risk donors more effectively.
    Type of Medium: Online Resource
    ISSN: 0041-1132 , 1537-2995
    URL: Issue
    URL: Article
    DOI: 10.1111/trf.2013.53.issue-10pt2
    DOI: 10.1111/trf.12062
    Language: English
    Publisher: Wiley
    Publication Date: 2013
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  • 2
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    The persistence of hepatitis C virus transmission risk in C hina despite serologic screening of blood donations
    Wiley ; 2013
    In:  Transfusion Vol. 53, No. 10pt2 ( 2013-10), p. 2489-2497
    Details
    In: Transfusion, Wiley, Vol. 53, No. 10pt2 ( 2013-10), p. 2489-2497
    Abstract: A total of 2%‐2.9% of the population in C hina is infected with hepatitis C virus ( HCV ). This study estimated the prevalence and incidence of HCV among C hinese blood donors. Study Design and Methods We examined whole blood and apheresis platelet donations at five Chinese blood centers in 2008 to 2010. All donations were screened using two rounds of testing for alanine aminotransferase, antibody to human immunodeficiency virus Types 1 and 2, hepatitis  B surface antigen, anti‐ HCV , and syphilis. Screening reactivity is defined by a reactive result in one or both rounds of screening tests. Confirmatory tests (Ortho third‐generation HCV enzyme immunoassay, J ohnson & J ohnson) were performed on anti‐ HCV screening–reactive samples. Confirmatory positive rates among first‐time donors (prevalence) and repeat donors (incidence) were calculated by blood center and demographic categories. Donor characteristics associated with HCV confirmatory status among first‐time donors were examined using trend test and multivariable logistic regression analysis. Results Among 821,314 donations, 40% came from repeat donors. The overall anti‐ HCV screening–reactive rate was 0.48%. Estimated HCV prevalence was 235 per 100,000 first‐time donors; incidence was 10 per 100,000 person‐years in repeat donors. In multivariable logistic regression analysis, first‐time donors older than 25 years displayed higher HCV prevalence than the younger donors. Less education is associated with higher HCV prevalence. Donors 26 to 35 years old and those above 45 years displayed the highest incidence rate. Conclusion High prevalence and incidence in donors indicate high residual risks for transfusion‐transmitted HCV in C hinese patients. Implementation of minipool nucleic acid testing in routine donation screening may prevent a substantial number of transfusion‐transmitted HCV infections.
    Type of Medium: Online Resource
    ISSN: 0041-1132 , 1537-2995
    URL: Issue
    URL: Article
    DOI: 10.1111/trf.2013.53.issue-10pt2
    DOI: 10.1111/trf.12297
    Language: English
    Publisher: Wiley
    Publication Date: 2013
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  • 3
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    Risk factors for hepatitis B and C infection among blood donors in five C hinese blood centers
    Wiley ; 2015
    In:  Transfusion Vol. 55, No. 2 ( 2015-02), p. 388-394
    Details
    In: Transfusion, Wiley, Vol. 55, No. 2 ( 2015-02), p. 388-394
    Abstract: Few studies were conducted on hepatitis B and C virus ( HBV and HCV , respectively) risk factors among C hinese blood donors in recent years since voluntary donors replaced commercial donors. Study Design and Methods A case‐control survey was conducted in HBV ‐ or HCV ‐positive and ‐negative donors from five blood centers in C hina between S eptember 2009 and A pril 2011. Case status was defined by having a reactive result on M onolisa HBsAg U ltra ( B io‐ R ad) for HBV and O rtho anti‐ HCV EIA 3.0 ( J ohnson & J ohnson) for HCV . Controls were randomly selected qualified blood donors matched to cases by donation month and blood center. Specific test‐seeking, medical‐related, and behavioral risk factors were compared by HBV and HCV status using chi‐square tests or F isher's exact tests with B onferroni correction. Results A total of 364 HBV cases, 174 HCV cases, and 689 controls completed the survey; response rates were 66.2, 47.3, and 82%, respectively. HCV ‐positive donors were significantly more likely to report having a blood transfusion history (23.4% vs. 3.0%, p  〈  0.0001) and ever living with a person with illegal drug injection (6.0% vs. 0.5%, p  〈  0.0001) than controls. Having intravenous and intramuscular injections in the past 12 months and ever having a tattoo are marginal risk factors for HCV (p values  〈  0.01). No specific risk factor for HBV was identified. Conclusion History of previous transfusion and living with illegal drug users are risk factors for HCV infection among C hinese blood donors from five regions. Test‐seeking behavior is not associated with HBV or HCV infections.
    Type of Medium: Online Resource
    ISSN: 0041-1132 , 1537-2995
    URL: Issue
    URL: Article
    DOI: 10.1111/trf.v55.2
    DOI: 10.1111/trf.12850
    Language: English
    Publisher: Wiley
    Publication Date: 2015
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  • 4
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    Prevalence of serologic markers for hepatitis B and C viruses in Brazilian blood donors and incidence and residual risk of transfusion transmission of hepatitis C virus
    Wiley ; 2013
    In:  Transfusion Vol. 53, No. 4 ( 2013-04), p. 827-834
    Details
    In: Transfusion, Wiley, Vol. 53, No. 4 ( 2013-04), p. 827-834
    Abstract: BACKGROUND: We evaluate the current prevalence of serologic markers for hepatitis B virus (HBV) and hepatitis C virus (HCV) in blood donors and estimated HCV incidence and residual transfusion‐transmitted risk at three large Brazilian blood centers. STUDY DESIGN AND METHODS: Data on whole blood and platelet donations were collected from January through December 2007, analyzed by center; donor type; age; sex; donation status; and serologic results for hepatitis B surface antigen (HBsAg), antibody to hepatitis B core antigen (anti‐HBc), and anti‐HCV. HBV and HCV prevalence rates were calculated for all first‐time donations. HCV incidence was derived including interdonation intervals that preceded first repeat donations given during the study, and HCV residual risk was estimated for transfusions derived from repeat donors. RESULTS: There were 307,354 donations in 2007. Overall prevalence of concordant HBsAg and anti‐HBc reactivity was 289 per 100,000 donations and of anti‐HCV confirmed reactivity 191 per 100,000 donations. There were significant associations between older age and hepatitis markers, especially for HCV. HCV incidence was 3.11 (95% confidence interval, 0.77‐7.03) per 100,000 person‐years, and residual risk of HCV window‐phase infections was estimated at 5.0 per million units transfused. CONCLUSION: Improvement in donor selection, socioeconomic conditions, and preventive measures, implemented over time, may have helped to decrease prevalence of HBV and HCV, relative to previous reports. Incidence and residual risk of HCV are also diminishing. Ongoing monitoring of HBV and HCV markers among Brazilian blood donors should help guide improved recruitment procedures, donor selection, laboratory screening, and counseling strategies.
    Type of Medium: Online Resource
    ISSN: 0041-1132 , 1537-2995
    URL: Issue
    URL: Article
    DOI: 10.1111/trf.2013.53.issue-4
    DOI: 10.1111/j.1537-2995.2012.03840.x
    Language: English
    Publisher: Wiley
    Publication Date: 2013
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  • 5
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    Detection of Trypanosoma cruzi DNA in blood by PCR is associated with Chagas cardiomyopathy and disease severity
    Wiley ; 2015
    In:  European Journal of Heart Failure Vol. 17, No. 4 ( 2015-04), p. 416-423
    Details
    In: European Journal of Heart Failure, Wiley, Vol. 17, No. 4 ( 2015-04), p. 416-423
    Abstract: The significance of detection of Trypanosoma cruzi DNA in blood of antibody‐positive patients for risk of development of Chagas heart disease is not well established. The objective of this study was to compare detection of T. cruzi DNA with known clinical and laboratory markers of Chagas cardiomyopathy ( CC ) severity. Methods This is a case–control study nested within a retrospective cohort developed in Brazil to understand the natural history of Chagas disease. The study enrolled 499 T. cruzi seropositive blood donors ( SP‐BD ) and 488 frequency matched seronegative control donors ( SN‐BD ) who had donated between 1996 and 2002, and 101 patients with clinically diagnosed CC . In 2008–2010 all enrolled subjects underwent a health questionnaire, medical examination, electrocardiograms and echocardiograms and polymerase chain reaction ( PCR ) analyses. A blinded panel of three cardiologists adjudicated the outcome of CC . Trypanosoma cruzi kinetoplast minicircle sequences were amplified by real‐time PCR using an assay with a sensitivity of one parasite per 20  mL of blood. All testing was performed on coded samples. Results Rates of PCR detection of T. cruzi DNA were significantly ( P  = 0.003) higher in CC patients and SP‐BD diagnosed with CC (79/105 [75.2 %]) compared with SP‐BD without CC (143/279 [51.3%]). The presence of parasitaemia was significantly associated with known markers of disease progression such as QRS and QT interval duration, lower left ventricular ejection fraction, higher left ventricular index mass, and elevated troponin and NTpro‐BNP levels. Conclusion Trypanosoma cruzi PCR positivity is associated with presence and severity of cardiomyopathy, suggesting a direct role of parasite persistence in disease pathogenesis.
    Type of Medium: Online Resource
    ISSN: 1388-9842 , 1879-0844
    URL: Issue
    URL: Article
    DOI: 10.1002/ejhf.2015.17.issue-4
    DOI: 10.1002/ejhf.220
    Language: English
    Publisher: Wiley
    Publication Date: 2015
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  • 6
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    Enhanced classification of Chagas serologic results and epidemiologic characteristics of seropositive donors at three large blood centers in Brazil
    Wiley ; 2010
    In:  Transfusion Vol. 50, No. 12 ( 2010-12), p. 2628-2637
    Details
    In: Transfusion, Wiley, Vol. 50, No. 12 ( 2010-12), p. 2628-2637
    Abstract: BACKGROUND: A major problem in Chagas disease donor screening is the high frequency of samples with inconclusive results. The objective of this study was to describe patterns of serologic results among donors to the three Brazilian REDS‐II blood centers and correlate with epidemiologic characteristics. STUDY DESIGN AND METHODS: The centers screened donor samples with one Trypanosoma cruzi lysate enzyme immunoassay (EIA). EIA‐reactive samples were tested with a second lysate EIA, a recombinant‐antigen based EIA, and an immunfluorescence assay. Based on the serologic results, samples were classified as confirmed positive (CP), probable positive (PP), possible other parasitic infection (POPI), and false positive (FP). RESULTS: In 2007 to 2008, a total of 877 of 615,433 donations were discarded due to Chagas assay reactivity. The prevalences (95% confidence intervals [CIs]) among first‐time donors for CP, PP, POPI, and FP patterns were 114 (99‐129), 26 (19‐34), 10 (5‐14), and 96 (82‐110) per 100,000 donations, respectively. CP and PP had similar patterns of prevalence when analyzed by age, sex, education, and location, suggesting that PP cases represent true T. cruzi infections; in contrast the demographics of donors with POPI were distinct and likely unrelated to Chagas disease. No CP cases were detected among 218,514 repeat donors followed for a total of 718,187 person‐years. CONCLUSION: We have proposed a classification algorithm that may have practical importance for donor counseling and epidemiologic analyses of T. cruzi –seroreactive donors. The absence of incident T. cruzi infections is reassuring with respect to risk of window phase infections within Brazil and travel‐related infections in nonendemic countries such as the United States.
    Type of Medium: Online Resource
    ISSN: 0041-1132 , 1537-2995
    URL: Issue
    URL: Article
    DOI: 10.1111/trf.2010.50.issue-12
    DOI: 10.1111/j.1537-2995.2010.02756.x
    Language: English
    Publisher: Wiley
    Publication Date: 2010
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  • 7
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    The increasing prevalence of serologic markers for syphilis among Chinese blood donors in 2008 through 2010 during a syphilis epidemic
    Wiley ; 2012
    In:  Transfusion Vol. 52, No. 8 ( 2012-08), p. 1741-1749
    Details
    In: Transfusion, Wiley, Vol. 52, No. 8 ( 2012-08), p. 1741-1749
    Abstract: BACKGROUND: In China, the growing syphilis epidemic parallels the spread of human immunodeficiency virus (HIV) in the general population. This study evaluated the prevalence and incidence of serologic markers for syphilis among donors at five Chinese blood centers. STUDY DESIGN AND METHODS: We examined whole blood and apheresis donations collected from January 2008 through December 2010. Postdonation testing of syphilis was conducted using two different Treponema pallidum antibody enzyme‐linked immunosorbent assay kits. The prevalence of serologic markers for syphilis (%), and the rate of coinfection with HIV‐1/2, hepatitis B virus (HBV), and hepatitis C virus (HCV) were calculated. A multivariable logistic regression analysis was conducted examining donor characteristics associated with positive syphilis serology. Seroconversion rate and syphilis incidence were estimated. RESULTS: Of 801,511 donations, 60% were from first‐time donors and 40% were from repeat donors. There was a significant increase in syphilis serologic markers among first‐time donors with 0.41, 0.45, and 0.57% positivity over 3 years (p  〈  0.001). Approximately 2.8, 0.8, and 0.5% of HIV‐1/2–, HBV‐, and HCV‐positive donations also tested reactive for syphilis. Logistic regression results suggest that first‐time donors were nine times more likely to be syphilis positive than repeat donors. Higher syphilis positivity was associated with donors older than 25 years and with less education. Estimated incidence among repeat donations was 33 (95% confidence interval, 29‐39) per 100,000 person‐years. CONCLUSION: The increase in syphilis serologic prevalence reflected the syphilis epidemic in the general population. Without screening, most of these syphilis‐positive donations would get into the blood supply. Thus, during a syphilis epidemic, continued syphilis screening of blood donations may be important to maintain blood safety and public health.
    Type of Medium: Online Resource
    ISSN: 0041-1132 , 1537-2995
    URL: Issue
    URL: Article
    DOI: 10.1111/trf.2012.52.issue-8
    DOI: 10.1111/j.1537-2995.2011.03527.x
    Language: English
    Publisher: Wiley
    Publication Date: 2012
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  • 8
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    Analysis of donor deferral at three blood centers in Brazil
    Wiley ; 2013
    In:  Transfusion Vol. 53, No. 3 ( 2013-03), p. 531-538
    Details
    In: Transfusion, Wiley, Vol. 53, No. 3 ( 2013-03), p. 531-538
    Abstract: BACKGROUND: The safety of the blood supply is ensured through several procedures from donor selection to testing of donated units. Examination of the donor deferrals at different centers provides insights into the role that deferrals play in transfusion safety. STUDY DESIGN AND METHODS: A cross‐sectional descriptive study of prospective allogeneic blood donors at three large blood centers located in São Paulo, Belo Horizonte, and Recife, Brazil, from August 2007 to December 2009 was conducted. Deferrals were grouped into similar categories across the centers, and within each center frequencies out of all presentations were determined. RESULTS: Of 963,519 prospective blood donors at the three centers, 746,653 (77.5%) were accepted and 216,866 (22.5%) were deferred. Belo Horizonte had the highest overall deferral proportion of 27%, followed by Recife (23%) and São Paulo (19%). Females were more likely to be deferred than males (30% vs. 18%, respectively). The three most common deferral reasons were low hematocrit or hemoglobin, medical diagnoses, and higher‐risk behavior. CONCLUSION: The types and frequencies of deferral vary substantially among the three blood centers. Factors that may explain the differences include demographic characteristics, the order in which health history and vital signs are taken, the staff training, and the way deferrals are coded by the centers among other policies. The results indicate that blood donor deferral in Brazil has regional aspects that should be considered when national policies are developed.
    Type of Medium: Online Resource
    ISSN: 0041-1132 , 1537-2995
    URL: Issue
    URL: Article
    DOI: 10.1111/trf.2013.53.issue-3
    DOI: 10.1111/j.1537-2995.2012.03820.x
    Language: English
    Publisher: Wiley
    Publication Date: 2013
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  • 9
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    First‐time donors responding to a national disaster may be an untapped resource for the blood centre
    Wiley ; 2012
    In:  Vox Sanguinis Vol. 102, No. 4 ( 2012-05), p. 338-344
    Details
    In: Vox Sanguinis, Wiley, Vol. 102, No. 4 ( 2012-05), p. 338-344
    Abstract: Background  On 12 May 2008, a severe earthquake struck Sichuan in China. Many people donated blood for the first time, leading us to question whether these donors might become repeat donors in the future. The return pattern of post‐earthquake first‐time donors (PEFTD) was compared with that of first‐time donors (FTD) in a comparable period. Methods  Demographic characteristics, transfusion‐transmissible infection rates and 1‐year return rates were compared between 5147 PEFTD (5/13‐5/19, 2008) and 3176 FTD (5/13‐5/19, 2009) from five Chinese blood centres using chi‐squared tests. Adjusted logistic regression was used to detect earthquake effect on donor return. Results  Post‐earthquake first‐time donors were more frequently between 26 and 45 years, men, and better educated compared with the control group. Slightly higher but not statistically significant increased rates of hepatitis B virus surface antigen (HBsAg) (0·87% vs. 0·50%, P  = 0·054), hepatitis C virus (HCV) (0·70% vs. 0·63%, P  = 0·414), syphilis (0·9% vs. 0·7%, P  = 0·489) and lower rates of human immunodeficiency virus (HIV) (0·31% vs. 0·60%, P  = 0·078) reactivity were detected for PEFTD. The 1‐year return rate for PEFTD was significantly lower than that of the controls (8·0% vs. 13·0%, P   〈  0·001). After adjusting for demographic factors, donation volume and sites, the PEFTD were less likely to return in 1 year than the controls (OR: 0·520; 95% CI: 0·442, 0·611). Conclusion  Post‐earthquake first‐time donors may be less likely to donate again without continuing motivation strategies. Further studies on PEFTD’s lack of motivation to return for donation are needed to design recruitment strategies to convert PEFTD to become repeat donors to continuously replenish the blood supply.
    Type of Medium: Online Resource
    ISSN: 0042-9007 , 1423-0410
    URL: Issue
    URL: Article
    DOI: 10.1111/vox.2012.102.issue-4
    DOI: 10.1111/j.1423-0410.2011.01557.x
    Language: English
    Publisher: Wiley
    Publication Date: 2012
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  • 10
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    Risk factors for human immunodeficiency virus infection among Brazilian blood donors: a multicentre case–control study using audio computer‐assisted structured interviews
    Wiley ; 2013
    In:  Vox Sanguinis Vol. 105, No. 2 ( 2013-08), p. 91-99
    Details
    In: Vox Sanguinis, Wiley, Vol. 105, No. 2 ( 2013-08), p. 91-99
    Abstract: Although risk factors for HIV infection are known, it is important for blood centres to understand local epidemiology and disease transmission patterns. Current risk factors for HIV infection in blood donors in Brazil were assessed. Methods A case–control study was conducted at large public blood centres located in four major cities between April 2009 and March 2011. Cases were persons whose donations were confirmed positive by enzyme immunoassays followed by Western blot confirmation. Audio computer‐assisted structured interviews ( ACASI ) were completed by all cases and controls. Multivariable logistic regression was used to estimate adjusted odds ratios ( AOR s) and associated 95% confidence intervals ( CI s). Results There were 341 cases, including 47 with recently acquired infection, and 791 controls. Disclosed risk factors for both females and males were sex with an HIV ‐positive person AOR 11·3, 95% CI (4·1, 31·7) and being an IVDU or sexual partner of an IVDU [ AOR 4·65 (1·8, 11·7)]. For female blood donors, additional risk factors were having male sex partners who also are MSM [ AOR 13·5 (3·1, 59·8)] and having unprotected sex with multiple sexual partners [ AOR 5·19 (2·1, 12·9)]. The primary risk factor for male blood donors was MSM activity [ AOR 21·6 (8·8, 52·9)]. Behaviours associated with recently acquired HIV were being a MSM or sex partner of MSM [13·82, (4·7, 40·3)] and IVDU [11·47, (3·0, 43·2)]. Conclusion Risk factors in blood donors parallel those in the general population in Brazil. Identified risk factors suggest that donor compliance with selection procedures at the participating blood centres is inadequate.
    Type of Medium: Online Resource
    ISSN: 0042-9007 , 1423-0410
    URL: Issue
    URL: Article
    DOI: 10.1111/vox.2013.105.issue-2
    DOI: 10.1111/vox.12028
    Language: English
    Publisher: Wiley
    Publication Date: 2013
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