1
|
Jaime-Pérez JC, Colunga-Pedraza JE, Monreal-Robles R, Colunga-Pedraza PR, Méndez-Ramírez N, Salazar-Riojas R, Gómez-Almaguer D. Acute maternal cytomegalovirus infection is associated with significantly decreased numbers of CD34+ cells in umbilical cord blood. Blood Cells Mol Dis 2012; 49:166-9. [PMID: 22818857 DOI: 10.1016/j.bcmd.2012.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Accepted: 06/19/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVE AND BACKGROUND There is little information regarding the serologic status of umbilical cord blood (UCB) donors. Cytomegalovirus (CMV) is the most frequent agent transmitted by blood products and studies have reported that CMV can inhibit myelopoiesis, however, its effects on the cellular content of UCB have not been documented. STUDY DESIGN AND METHODS We investigated, retrospectively, the prevalence of serological evidence of infection in 857 women donating their UCB at a public university hospital and studied the influence of acute CMV exposure on UCB content of CD34+ cells. The biological characteristics of UCB from serology positive-donors were compared with those of women with negative tests. RESULTS We found that 51 of 857 (6%) UCB units were positive for infectious disease markers; anti-CMV IgM was the most prevalent marker, 43 of 51 (86%) of cases with infectious markers. UCB collected from anti-CMV IgM-positive donors more frequently met rejection criteria for use as a transplanation product. The CD34+ cell count was the most often affected, 2.48×10(6) in anti-CMV IgM-positive donors compared to 1.48×10(6) in unaffecetd donors( p=0.006). The probability of a UCB meeting a CD34+ cell content≥2×10(6) was significantly lower in units from IgM anti-CMV+ women compared to unaffecetd donors [Odds ratio (OR)=0.428 (95% CI 0.182-0.632; p=0.015]; the total nucleated cell count (TNC) was lower but not statistically significant [p=0.068]. CONCLUSION UCB donated by anti-CMV IgM-positive women has a high probability of not meeting the criteria required for cryopreservation for future use as a transplantation product, because of the low number of CD34+ cells.
Collapse
Affiliation(s)
- José C Jaime-Pérez
- Hematology Department, Dr. José Eleuterio González University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, Mexico.
| | | | | | | | | | | | | |
Collapse
|
2
|
Berntorp E, Keeling D, Makris M, Tagliaferri A, Male C, Mauser-Bunschoten EP, Musso R, Roca CA, Hassoun A, Kollmer C, Charnigo R, Baumann J, Rendo P. A prospective registry of European haemophilia B patients receiving nonacog alfa, recombinant human factor IX, for usual use. Haemophilia 2011; 18:503-9. [PMID: 22044794 DOI: 10.1111/j.1365-2516.2011.02685.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Nonacog alfa, a recombinant factor IX (FIX) used for the treatment of haemophilia B, was approved in Europe in 1998. In accordance with European Medicines Agency requirements, a registry study was conducted from 2002 to 2009. A reformulated iso-osmotic version was approved for European use in 2007. This study was conducted to evaluate the safety of nonacog alfa in a usual care setting, and provide clinical trial and postmarketing surveillance data support. This open-label, non-interventional, prospective observational cohort study (registry) comprised 52 sites in nine European countries. Patients with haemophilia B receiving nonacog alfa in either formulation for prevention or treatment were followed on a usual care schedule. A total of 218 patients were enrolled, of whom 66 (30.3%) were <18 years of age. Haemophilia severity was evenly distributed, with baseline FIX activity of <1%, 1-5% and >5% in 33.3%, 36.6% and 30.1% of patients, respectively. One hundred thirty-eight patients received the original formulation alone; 80 switched to or received only the new formulation. There was a low incidence of events of special interest (ESIs), with less-than-expected therapeutic effect in five patients (2.2%), inhibitor development in two (0.9%), thrombosis in one (0.5%) and allergic events in eight (3.7%). These accounted for the majority of the 15 serious AEs reported in six patients. Six patients discontinued because of AEs, primarily related to hypersensitivity. Nonacog alfa was shown to be safe for the treatment of haemophilia B, with a low incidence of serious AEs and ESIs.
Collapse
Affiliation(s)
- E Berntorp
- Malmö Centre for Thrombosis and Haemostasis, Lund University, Skåne University Hospital, SE-205 02, Malmö, Sweden.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Hannachi N, Boughammoura L, Marzouk M, Tfifha M, Khlif A, Soussi S, Skouri H, Boukadida J. [Viral infection risk in polytransfused adults: seroprevalence of seven viruses in central Tunisia]. ACTA ACUST UNITED AC 2011; 104:220-5. [PMID: 21695497 DOI: 10.1007/s13149-010-0103-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2010] [Accepted: 10/05/2010] [Indexed: 12/21/2022]
Abstract
The aim of this study is to evaluate the prevalence of seven transfusion-transmitted viruses in polytransfused adults and children comparatively with a group of healthy control subjects. We studied 107 polytransfused patients (59 adults and 48 children) and 160 control subjects (100 blood donors and 60 children). Immunoenzymatic tests were used for detection of HBs antigen (HBs Ag), antibodies against hepatitis C Virus (anti-HCV), and human immunodeficiency virus (anti-HIV), and IgG antibodies against human cytomegalovirus (IgG anti-CMV), human parvovirus B19 (IgG anti-PB19), and hepatitis E virus (IgG anti-HEV). An immunofluorescent assay was performed for the detection of human herpesvirus 8 antibodies (anti-HHV8). Prevalence of HBs Ag, anti-HCV, anti-HIV, IgG anti-CMV, IgG anti-PB19, IgG anti-HEV, and anti-HHV8 in polytransfused group was 8.4, 4.7, 0, 86.9, 60.7, 28.9, and 47.6%, respectively, and 1.8, 0.6, 0, 86.2, 53.1, 10, and 12.5%, respectively, in the control group. The difference in prevalence between the two groups was statistically significant for HBs Ag (P = 0.01), anti-HCV (P = 0.03), IgG anti-HEV (P < 10(-4)), and IgG anti-HHV8 (P < 10(-4)). Categorization according to age showed that hepatitis B and C risk was limited in adult polytransfused group. HHV8 infection was higher in polytransfused subjects born before the use of leucocyte-depleted blood components. Our results corroborate literature data on the risk of HEV and HHV8 infection by blood transfusion. Hepatitis B vaccination and improvement in screening tests have an important role in reduction of hepatitis B and C risk in transfusion, especially in young polytransfused persons. However, a residual risk of transmitting viral infections persists, and efforts are needed to improve transfusion safety.
Collapse
Affiliation(s)
- N Hannachi
- Laboratoire de microbiologie-immunologie, UR02SP13, CHU Farhat-Hached, Sousse, Tunisie.
| | | | | | | | | | | | | | | |
Collapse
|
4
|
Juhl D, Mosel C, Nawroth F, Funke AM, Dadgar SM, Hagenström H, Kirchner H, Hennig H. Detection of herpes simplex virus DNA in plasma of patients with primary but not with recurrent infection: implications for transfusion medicine? Transfus Med 2010; 20:38-47. [DOI: 10.1111/j.1365-3148.2009.00951.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
5
|
Removal and inactivation of viruses during the manufacture of a high-purity antihemophilic factor IX from human plasma. BIOTECHNOL BIOPROC E 2010. [DOI: 10.1007/s12257-009-0167-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
6
|
Liumbruno G, Bennardello F, Lattanzio A, Piccoli P, Rossetti G. Recommendations for the transfusion of plasma and platelets. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2009; 7:132-50. [PMID: 19503635 PMCID: PMC2689068 DOI: 10.2450/2009.0005-09] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Giancarlo Liumbruno
- UU.OO.CC. di Immunoematologia e Medicina Trasfusionale e Patologia Clinica, Ospedale San Giovanni Calibita Fatebenefratelli, Roma, Italy.
| | | | | | | | | |
Collapse
|
7
|
Abstract
OBJECTIVES To assess the risk to the Australian blood supply posed by emerging or re-emerging viral infections. METHOD A review was undertaken of the English-speaking literature on the potential for emerging viral threats to human health in Australia, the future implications of virus ecology, climate change and population movement and the implications for blood transfusion. RESULTS Published data confirm that Australia's blood supply is among the safest in the world for currently screened viral pathogens as a result of rigorous surveillance, donor selection and state-of-the-art processing and laboratory testing. However, Australia has a number of other viral pathogens with the potential to threaten the safety of the blood supply such as the Ross River, Barmah Forrest, Kunjin, Japanese Encephalitis, Murray Valley Encephalitis and dengue viruses. Of these, dengue is currently of most concern to blood safety because; it can cause fatalities, there are regular seasonal outbreaks in Northern Australia and, in contrast to other viruses mentioned above an overseas case of transfusion transmission has already been documented. Notably, despite the lack of a suitable dengue screening test the ARCBS already implements supplementary measures to protect the blood supply during outbreaks. CONCLUSION Current interventions have proven extremely effective in minimising transfusion transmission in Australia of recognised viral pathogens. The threat posed by emerging viral pathogens to the safety of blood transfusion emphasises the need for global collaboration and consideration of further intervention strategies on a country by country basis including options such as nucleic acid testing and pathogen reduction technologies.
Collapse
Affiliation(s)
- Robert A Dunstan
- School of Biomedical Sciences, the Western Australian Biomedical Research Institute, Curtin University, Perth, WA.
| | | | | |
Collapse
|
8
|
Liumbruno GM, Sodini ML, Grazzini G. Recommendations from the Tuscan Transfusion System on the appropriate use of solvent/detergent-inactivated fresh-frozen plasma. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2008; 6:25-36. [PMID: 18661921 PMCID: PMC2626856 DOI: 10.2450/2008.0027-07] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Revised: 06/04/2007] [Accepted: 12/05/2007] [Indexed: 01/14/2023]
|
9
|
|
10
|
Kraus AA, Priemer C, Heider H, Kruger DH, Ulrich R. Inactivation of Hantaan Virus-Containing Samples for Subsequent Investigations outside Biosafety Level 3 Facilities. Intervirology 2005; 48:255-61. [PMID: 15920350 DOI: 10.1159/000084603] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2004] [Accepted: 10/11/2004] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The potential risk of accidental infection by hantaviruses in a clinical or research laboratory necessitates special precautionary measures. A biosafety program must address handling and disposal of infectious materials as well as appropriate virus inactivation or depletion procedures to permit necessary further processing of specimens outside the biosafety level 3 laboratory. METHODS To study the elimination of hantavirus infectivity, the effects of different chemical and physical inactivation and depletion procedures were investigated on Hantaan virus-containing materials. An infectivity assay for hantaviruses was utilised to verify these procedures which are commonly preceding investigations such as ELISA, flow cytometry analysis, Western blot or immunofluorescence assay. RESULTS Chemical inactivation with methanol, paraformaldehyde, acetone/methanol and detergent-containing lysis buffer as well as physical forces such as UV irradiation and filtration efficiently reduced viral infectivity in infected cells and their supernatants below the detection limit. CONCLUSION The virus inactivation and depletion methods described herein are suitable to prepare non-infectious samples for further use in immunological, virological and cell-biological assays.
Collapse
Affiliation(s)
- Annette A Kraus
- Institut fur Virologie, Charité, Universitatsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | | | | | | | | |
Collapse
|
11
|
Kibler KV, Jeang KT. Human T-cell leukemia virus type I: 25 years of progress and challenges. J Biomed Sci 2005; 12:7-11. [PMID: 15864735 DOI: 10.1007/s11373-004-8164-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2004] [Accepted: 12/24/2004] [Indexed: 10/25/2022] Open
Affiliation(s)
- Karen V Kibler
- Center for Infectious Diseases and Vaccinology, Arizona State University, Tempe, AZ 85287, USA
| | | |
Collapse
|
12
|
|
13
|
|
14
|
Transfusion and risk of infection in Canada: UPDATE 2004. Can J Infect Dis 2004; 15:79-82. [PMID: 18159480 PMCID: PMC2094962 DOI: 10.1155/2004/651237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
15
|
|
16
|
Bonvicini F, Gallinella G, Cricca M, Ambretti S, Delbarba S, Musiani M, Zerbini M. Molecular testing for detection of in vitro infectivity of plasma pools contaminated with B19 virus. J Med Virol 2004; 74:272-6. [PMID: 15332276 DOI: 10.1002/jmv.20180] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
B19 virus can be transmitted by contaminated blood or blood products. Recent observations, in healthy volunteers, suggest that active B19 infection can follow the administration of plasma pools with a concentration > or =10(7) genome equivalents/ml (geq/ml) of B19 DNA. However, patients receiving batches with levels of virus DNA lower than 10(4) geq/ml do not show any evidence of transmission of the virus. The aim of the study was to show, by in vitro assays, a threshold of viral load in B19 contaminated plasma pools over which the infection can be transmitted. Twenty plasma pools, each containing 960 single donations, were tested to correlate the viral load and the level of antibodies anti-B19 with the in vitro infectivity and expression of B19 virus. All the plasma pools, titrated for B19 viral load by competitive PCR, were inoculated into KU812Ep6 erythroid human cell line. Five of the nine contaminated plasma pools, with a B19 DNA concentration > or =3.60 x 10(6) geq/ml, were able to infect KU812Ep6 cells. In vitro infectivity was shown in KU812Ep6 cells at 24 h post-infection by in situ hybridisation and amplification assays for viral DNA and RNAs. Plasma pools with a viral load in the range of 6.00 x 10(3)-8.96 x 10(4) geq/ml did not show infectivity when inoculated into KU812Ep6 cells. Medium-high titres of IgG antibodies anti-B19 were detectable in all the plasma pools and the neutralising activity associated with specific IgG anti-B19 may explain the lack of infectivity of plasma pools contaminated with a low viral load. In conclusion, in situ hybridisation and amplification assays for viral DNA and RNAs in KU812Ep6 cells inoculated with plasma pools can be valid assays to test for the presence of infectious virus in the production of B19-safe material.
Collapse
Affiliation(s)
- F Bonvicini
- Department of Clinical and Experimental Medicine, Division of Microbiology, University of Bologna, Bologna, Italy
| | | | | | | | | | | | | |
Collapse
|
17
|
Trejo SR, Hotta JA, Lebing W, Stenland C, Storms RE, Lee DC, Li H, Petteway S, Remington KM. Evaluation of virus and prion reduction in a new intravenous immunoglobulin manufacturing process. Vox Sang 2003; 84:176-87. [PMID: 12670366 DOI: 10.1046/j.1423-0410.2003.00279.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVES Minimizing the transmission risk of infectious diseases is of primary importance in the manufacture of products derived from human plasma. A novel chromatography-based intravenous immunoglobulin (IGIV) manufacturing process was developed and the reduction of virus and transmissible spongiform encephalopathies (TSE) during the manufacturing process was assessed. Mechanistically distinct steps that could affect virus reduction were identified, and the robustness of virus reduction over the range of process conditions was determined. MATERIALS AND METHODS Virus and TSE reduction by processing steps were assessed using a scaled-down version of the IGIV manufacturing process. RESULTS Virus and TSE reduction at manufacturing process set points were well within safety standards. Robustness studies verified that the reproducibility of virus reduction was maintained at or beyond operating parameter extremes. Virus reduction across two combined manufacturing steps was lower than the sum of virus-reduction values across the individual steps, indicating mechanistic similarity of the two steps with respect to virus reduction. Only reduction from mechanistically distinct steps was claimed. CONCLUSIONS This comprehensive approach to pathogen safety provides the new immunoglobulin manufacturing process with a detailed, yet realistic, assessment of the risk of transmission of infectious pathogens.
Collapse
Affiliation(s)
- S R Trejo
- Pre-Clinical Research and Pathogen Safety, Bayer Healthcare, Biological Products Division, Research Triangle Park, North Carolina, USA
| | | | | | | | | | | | | | | | | |
Collapse
|