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Piron M, Salvador F, Caballero E, Sánchez-Montalvá A, Bes M, Casamitjana N, Puig L, Molina I, Sauleda S. HTLV-1/2 Infection in Blood Donors from a Non-Endemic Area (Catalonia, Spain) between 2008 and 2017: A 10-Year Experience. Viruses 2022; 14:v14091975. [PMID: 36146780 PMCID: PMC9504911 DOI: 10.3390/v14091975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 01/19/2023] Open
Abstract
Human T-cell lymphotropic virus type 1 and 2 (HTLV-1/2) screening is not mandatory in Spanish blood banks. In Catalonia, selective screening was introduced in 2008, followed by universal screening in 2011. We present herein a 10-year experience of HTLV testing in blood donors. HTLV-1/2 selective screening was performed using Ortho-Clinical Diagnostics HTLV-I/HTLV-II Ab-Capture ELISA between February 2008 and May 2009, then Abbott Prism HTLV-I/ HTLV-II assay until December 2010. Abbott Architect rHTLV-I/II assay was then used for HTLV-1/2 universal screening in pooled samples. INNO-LIA HTLV I/II Score (Fujirebio) and in-house HTLV-1/2 proviral DNA real-time PCR were used in reactive samples. Follow-up was offered to confirm HTLV-1/2 donors in Vall d’Hebron Hospital. Between 2008 and 2017, 51 blood donors were confirmed HTLV positive (46 HTLV-1, 4 HTLV-2 and 1 HTLV) out of 2,114,891 blood donations (1 in 41,468). Sixty-nine percent were female, median age was 40 years and most were born in Latin America (69%), followed by Europe (25%), Africa (4%) and Asia (2%). Screening of relatives and partners identified 12 additional HTLV-1 cases. Lookback studies did not show any HTLV-1/2 transmission. HTLV infections found in blood donors mirror epidemiological changes in the population of Spain. Consequently, HTLV should be considered a potential risk for recipients and calls for the design of optimal strategies to ensure transfusion safety.
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Affiliation(s)
- Maria Piron
- Banc de Sang i Teixits de Catalunya (Blood and Tissue Bank of Catalonia, BST), Transfusion Safety Laboratory, 08005 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREhd), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Vall d’Hebron Research Institute (VHIR), Vall d’Hebron University Hospital, 08035 Barcelona, Spain
- Correspondence: ; Tel.: +34-93-557-35-00 (ext. 6631)
| | - Fernando Salvador
- International Health Unit Vall d’Hebron-Drassanes, Infectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Estrella Caballero
- Laboratory of Microbiology, Vall d’Hebron University Hospital, 08035 Barcelona, Spain
| | - Adrián Sánchez-Montalvá
- International Health Unit Vall d’Hebron-Drassanes, Infectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Marta Bes
- Banc de Sang i Teixits de Catalunya (Blood and Tissue Bank of Catalonia, BST), Transfusion Safety Laboratory, 08005 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREhd), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Vall d’Hebron Research Institute (VHIR), Vall d’Hebron University Hospital, 08035 Barcelona, Spain
| | - Natàlia Casamitjana
- Banc de Sang i Teixits de Catalunya (Blood and Tissue Bank of Catalonia, BST), Transfusion Safety Laboratory, 08005 Barcelona, Spain
| | - Lluís Puig
- Banc de Sang i Teixits de Catalunya (Blood and Tissue Bank of Catalonia, BST), Transfusion Safety Laboratory, 08005 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREhd), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Israel Molina
- International Health Unit Vall d’Hebron-Drassanes, Infectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Silvia Sauleda
- Banc de Sang i Teixits de Catalunya (Blood and Tissue Bank of Catalonia, BST), Transfusion Safety Laboratory, 08005 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREhd), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Vall d’Hebron Research Institute (VHIR), Vall d’Hebron University Hospital, 08035 Barcelona, Spain
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2
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Williams P, O'Flaherty N, Field S, Waters A. Human T-lymphotropic virus in Irish blood donors: Impact on future testing strategy. Transfusion 2022; 62:1799-1807. [PMID: 35829653 PMCID: PMC9539962 DOI: 10.1111/trf.17017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 06/09/2022] [Accepted: 06/09/2022] [Indexed: 11/30/2022]
Abstract
Aim A risk‐based approach to the testing of blood donations for Human T‐Lymphotropic Virus (HTLV) should include an assessment of blood donation seroepidemiology. The objectives of the present study were to determine the proportion of HTLV positive units in Irish blood donations, and subsequently, to estimate the current risk of transfusion transmitted HTLV (TT‐HTLV). Methods Over 3 million donations screened between 1996 and 2020, were included in the study (n = 3,666,253). Factors considered in the assessment of TT‐HTLV risk included: (I) HTLV seropositivity, (ii) probability of a leucodepletion failure, and (iii) the HTLV testing strategy. Results Six HTLV positive donations were detected throughout the study period, all of them in previously unscreened blood donors (0.000164%; n = 6/3,666,253), 3 of whom had donated prior to the introduction of HLTV antibody testing. On average 0.11% of manufactured blood components assessed, failed to satisfy the leucodepletion quality assurance criteria of less than 1 × 106 cells/unit. In using these values to model the risk of TT‐HTLV, it was shown that the combination of leucodepletion with either universal screening of all = donors, or selective testing of first‐time donors, a possible HTLV transfusion transmitted infection would be prevented every 468–3776 years. Conclusions This is the first report on the proportion of HTLV positive in Irish blood donations (1996–2020) and will be used to inform blood donation screening policy in Ireland. Evidence is provided for recommending a selective HTLV donor screening algorithm in Ireland that is accompanied by a robust framework for continued surveillance of leucodepletion failure rate.
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Affiliation(s)
- Pádraig Williams
- Irish Blood Transfusion Service, National Blood Centre, Dublin, Ireland
| | - Niamh O'Flaherty
- Irish Blood Transfusion Service, National Blood Centre, Dublin, Ireland.,UCD National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - Stephen Field
- Irish Blood Transfusion Service, National Blood Centre, Dublin, Ireland.,School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Allison Waters
- Irish Blood Transfusion Service, National Blood Centre, Dublin, Ireland.,UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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3
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da Silva RX, Campos KR, Caterino-de-Araujo A. Pooling of sera for human T-cell lymphotropic virus (HTLV) screening in a time of increasing health care expenditure and limited resources. Rev Inst Med Trop Sao Paulo 2020; 62:e27. [PMID: 32401960 PMCID: PMC7232958 DOI: 10.1590/s1678-9946202062027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/14/2020] [Indexed: 12/15/2022] Open
Abstract
Identifying the true prevalence of human T-cell lymphotropic virus, mostly type 1 (HTLV-1), and the number of patients with HTLV-1-associated diseases, in addition to introducing HTLV-1/2 serology during the prenatal of pregnant women and in individuals infected with other viruses that share transmission routes with HTLV-1, are actions that could help to recognize the importance of this virus by WHO and national health organizations, and to control its transmission/dissemination. As Brazil is endemic to HTLV and there is an increase in health care expenditure, but resources are limited, any strategy that could reduce the cost of HTLV screening is needed and welcomed. This study aimed to determine whether the strategy of pooling sera for HTLV antibody determination is feasible and reduces the costs. Two enzyme immunoassays (EIA Murex HTLV-I+II, Diasorin, UK, and Gold ELISA HTLV-1+2, REM Ind. Com. Ltda., SP, Brazil), and serum samples that resulted in different levels of HTLV-1/2 antibodies by EIA and of which a volume allowed assay validation were employed for analysis. The diagnostic sensitivity and specificity and Cohen's Kappa value, as well as the accuracy and precision were analyzed. After validating the five-sample pool using the EIA Murex (Cohen's Kappa = 1.0), the technique was employed for individual cost comparison in 2,625 serum samples from populations at risk of HTLV infections (HBV, HCV, and HIV-infected individuals). The results from individual and pooled samples confirmed the diagnostic sensitivity (100%) and specificity (100%) of the pooling and a cost minimization varying from 60.7% to 73.6%. In conclusion, the results of this study suggest the use of pooling sera in sero-epidemiological surveillance studies and possibly in prenatal care screening programs in Brazil.
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Affiliation(s)
- Rafael Xavier da Silva
- Secretaria de Estado da Saúde de São Paulo, Coordenadoria de Controle de Doença, Instituto Adolfo Lutz, Centro de Imunologia, São Paulo, São Paulo, Brazil
| | - Karoline Rodrigues Campos
- Secretaria de Estado da Saúde de São Paulo, Coordenadoria de Controle de Doença, Instituto Adolfo Lutz, Centro de Imunologia, São Paulo, São Paulo, Brazil
| | - Adele Caterino-de-Araujo
- Secretaria de Estado da Saúde de São Paulo, Coordenadoria de Controle de Doença, Instituto Adolfo Lutz, Centro de Imunologia, São Paulo, São Paulo, Brazil
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4
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Cardona-Arias JA, Vélez-Quintero C, Calle-González OV, Florez-Duque J, Zapata JC. Seroprevalence of human T-lymphotropic virus HTLV and its associated factors in donors of a blood bank of Medellín-Colombia, 2014-2018. PLoS One 2019; 14:e0221060. [PMID: 31404110 PMCID: PMC6690513 DOI: 10.1371/journal.pone.0221060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/29/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Research on HTLV in Colombia is limited; despite being an endemic country there are few studies on the magnitude of this infection. The aim of this study was to determine the seroprevalence of HTLV I/II and its associated factors in donors to a blood bank of Medellín Colombia, 2014-2018. METHODS This is a cross-sectional study of 52,159 donors with a secondary information source. Seroprevalence of HTLV I/II was determined with its confidence interval and the population characteristics were described by frequency and summary measures. To explore the associated factors, Pearson's Chi square test, Mann-Whitney U test, crude odds ratios were used and they were adjusted by logistic regression in SPSS 25.0. RESULTS 88% of the population lived in the metropolitan area, 68.5% belonged to the University. 76.2% were altruistic donors (unpaid donors who did not donate to a specific patient). 24.5% were repetitive (paid) donors. 75% of the donors were under 41 years old. The seroprevalence of HTLV I/II was 0.176% (95% CI = 0.139% -0.213%), being statistically lower in repetitive donors and men. CONCLUSION The seroprevalence of HTLV I/II infection in the studied blood bank is lower than that reported in other blood banks at the departmental and national levels. In Medellín, it was associated with the frequency of donation and gender, which is useful information for the hemovigilance programs of the city.
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Affiliation(s)
- Jaiberth Antonio Cardona-Arias
- School of Microbiology, University of Antioquia Faculty of Medicine, University Cooperative of Colombia, Medellín, Colombia
| | | | | | | | - Juan Carlos Zapata
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
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5
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Malik B, Taylor GP. Can we reduce the incidence of adult T-cell leukaemia/lymphoma? Cost-effectiveness of human T-lymphotropic virus type 1 (HTLV-1) antenatal screening in the United Kingdom. Br J Haematol 2018; 184:1040-1043. [DOI: 10.1111/bjh.15234] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Bassit Malik
- Section of Virology; Imperial College London, Norfolk Place; London UK
| | - Graham P. Taylor
- Section of Virology; Imperial College London, Norfolk Place; London UK
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6
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Ainley LI, Hewitt PE. Haematology patients and the risk of transfusion transmitted infection. Br J Haematol 2018; 180:473-483. [DOI: 10.1111/bjh.15030] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Louise I. Ainley
- Department of Haematology; Imperial College Healthcare NHS Trust; London UK
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7
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Tosswill JHC, Taylor GP. Interpretation of low reactivity in the Abbott Architect rHTLV I/II assay. Transfus Med 2017; 28:326-330. [PMID: 29067784 DOI: 10.1111/tme.12482] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 09/18/2017] [Accepted: 09/26/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of this study is to reduce donor tissue wastage. AIM The aim of this study is to determine, in the case of the Abbott Architect rHTLV I/II assay, whether a signal/cut-off (S/CO) ratio higher than the manufacturer's recommendation of 1·0 could be applied to diagnose significant HTLV-1 seroreactivity. BACKGROUND The detection of human T cell leukaemia virus type 1 (HTLV-1) infection is primarily based on serology often utilising random access platforms. Although current assays have high sensitivity and specificity, in low-prevalence regions, significant numbers of false-positive reactions occur. A comprehensive follow-up is difficult within the time frame of organ donation. This can lead to donor tissue wastage. METHODS A retrospective analysis of 12 250 samples previously tested on the Abbott Architect rHTLV I/II platform and further tested by confirmatory serology/molecular detection to determine the sensitivity and positive predictive value in the S/CO ratio range was conducted. RESULTS Where the sample S/CO ratio was >20 (n = 498), HTLV infection was confirmed in all but eight subjects. All of these eight had indeterminate confirmatory results, and none were found to be uninfected. Conversely, in the samples within the S/CO ratio range 1-4 (n = 271), no subject was subsequently found to be HTLV-infected although HTLV infection could not be excluded in all cases, primarily due to lack of follow-up samples (n = 60/271). CONCLUSIONS Samples with an S/CO ratio of <4·0 on the Abbott Architect rHTLV I/II platform represent a low risk of HTLV infection in the UK, and organs from such donors might reasonably be considered for transplantation, within the context of appropriate risk-benefit assessment.
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Affiliation(s)
- J H C Tosswill
- Virus Reference Department, Public Health England, London, UK
| | - G P Taylor
- Retrovirology and GU Medicine, Section of Virology, Department of Medicine, Imperial College London, London, UK
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8
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Yuguda S. Seroprevalence of Human T-Cell Lymphoma/Leukemia Virus Type-1 (HTLV-1) Antibodies among Blood Donors at Ibadan, Nigeria. ACTA ACUST UNITED AC 2017. [DOI: 10.15406/jhvrv.2017.05.00169] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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9
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Marano G, Vaglio S, Pupella S, Facco G, Catalano L, Piccinini V, Liumbruno GM, Grazzini G. Human T-lymphotropic virus and transfusion safety: does one size fit all? Transfusion 2015; 56:249-60. [PMID: 26388300 DOI: 10.1111/trf.13329] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 07/28/2015] [Accepted: 08/02/2015] [Indexed: 12/17/2022]
Abstract
Human T-cell leukemia viruses (HTLV-1 and HTLV-2) are associated with a variety of human diseases, including some severe ones. Transfusion transmission of HTLV through cellular blood components is undeniable. HTLV screening of blood donations became mandatory in different countries to improve the safety of blood supplies. In Japan and Europe, most HTLV-infected donors are HTLV-1 positive, whereas in the United States a higher prevalence of HTLV-2 is reported. Many industrialized countries have also introduced universal leukoreduction of blood components, and pathogen inactivation technologies might be another effective preventive strategy, especially if and when generalized to all blood cellular products. Considering all measures available to minimize HTLV blood transmission, the question is what would be the most suitable and cost-effective strategy to ensure a high level of blood safety regarding these viruses, considering that there is no solution that can be deemed optimal for all countries.
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Affiliation(s)
| | - Stefania Vaglio
- Italian National Blood Centre, National Institute of Health.,Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Rome, Italy
| | | | - Giuseppina Facco
- Italian National Blood Centre, National Institute of Health.,Immunohaemathology and Transfusion Medicine Unit, Azienda Ospedaliera Città Della Salute e Della Scienza, Turin, Italy
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10
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O'Brien SF, Goldman M, Scalia V, Yi QL, Fan W, Xi G, Dines IR, Fearon MA. The epidemiology of human T-cell lymphotropic virus types I and II in Canadian blood donors. Transfus Med 2013; 23:358-66. [PMID: 23859527 DOI: 10.1111/tme.12057] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 06/11/2013] [Accepted: 06/16/2013] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Blood donors in Canada have been tested for Human T-Cell Lymphotropic Virus (HTLV) since 1990. We report the epidemiology, risk factors and lookback/traceback of HTLV-positive donors/recipients. METHODS The annual HTLV rate was calculated from 1990 to 2010. Residual risk was estimated as the product of incidence and window period. Twenty-nine HTLV-positive donors and 116 matched controls (ratio 1 : 4) were interviewed about risk factors. For HTLV-positive donations, lookback investigations involved identification of all previous donations, and attempting to locate and test recipients. Traceback was initiated when transfusion transmission was queried for HTLV-positive blood recipients. All donors of products that the recipient received were identified, with an attempt to locate and test them. RESULTS The HTLV rate decreased from 9.35 per 100,000 donations in 1990 to 1.11 in 2010. The residual risk of infection was 1 in 7.6 million donations. In logistic regression birth overseas (OR 18.7), history of sexually transmitted diseases (OR 32.9), sex with unknown background (OR 5.4) and blood transfusion (OR 8.9) were significant predictors. In the lookback study, of 109 HTLV-positive donors, 508 components were transfused, of whom 147 recipients were tested and 18 (12%) were positive. All were transfused prior to the implementation of donor testing. Twenty-three traceback investigations were requested involving 324 transfused untested products,of whom 219 (67.6%) of donors were tested and 13 (6%) were positive for HTLV. CONCLUSIONS With testing of the blood supply, the risk from HTLV is very low and while most HTLV-positive donors have risk factors, deferrable risk is rare.
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Affiliation(s)
- S F O'Brien
- Canadian Blood Services, Ottawa, ON, Canada; Department of Epidemiology & Community Medicine
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11
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HTLV-1 in solid-organ transplantation: current challenges and future management strategies. Transplantation 2013; 94:1075-84. [PMID: 23060278 DOI: 10.1097/tp.0b013e318263ad7a] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Human T-cell lymphotrophic virus (HTLV)-1 has been reported after solid-organ transplantation, with a related fatal outcome in less than five cases. The natural history of HTLV-1 transmission from donor to recipient is unknown in this setting, because available screening platforms are suboptimal in low-prevalence areas and there is a lack of long-term follow-up. Minimizing organ wastage due to false-positive screening and avoiding donor-derived HTLV-associated diseases remain the goal. To date, only six HTLV-naive organ recipients from four donors (only one had confirmed HTLV) have developed HTLV-associated disease after transplantation. All of these cases were described in countries or from donors from HTLV-endemic regions. To the best of our knowledge, there have been no reported cases of donor-derived HTLV-1-associated death after organ transplantation in the world. Based on data from low-prevalence countries (Europe and the United States) and the current shortage of donor organs, it appears plausible to authorize the decision to transplant an organ without the prior knowledge of the donor's HTLV-1 status. Currently, it is not possible to exclude such transmission and recipients should be informed of the possible inadvertent transmission of this (and other) infections at the time of consent. In those cases where HTLV-1 transmission does occur, there may be a therapeutic window in which use of antiviral agents (i.e., zidovudine and raltegravir) may be of benefit. The development of national/international registries should allow a greater understanding of the extent and consequences of transmission risk and so allow a more evidence-based approach to management.
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12
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Hewitt PE, Davison K, Howell DR, Taylor GP. Human T-lymphotropic virus lookback in NHS Blood and Transplant (England) reveals the efficacy of leukoreduction. Transfusion 2013; 53:2168-75. [PMID: 23384161 DOI: 10.1111/trf.12105] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 12/04/2012] [Accepted: 12/13/2012] [Indexed: 12/01/2022]
Abstract
BACKGROUND Leukoreduction of blood components was introduced in the United Kingdom during 1998. Human T-lymphotropic virus (HTLV) screening of blood donations was introduced in 2002. NHS Blood and Transplant conducted an HTLV lookback on blood components issued before 2002. A proportion of included components were nonleukoreduced, although the majority were subject to white blood cell reduction measures. STUDY DESIGN AND METHODS A standard lookback was conducted on untested cellular blood components from donors later confirmed to be HTLV positive, for the 4 to 5 years before 2002, and on the last tested negative donation from donors who had seroconverted. RESULTS A total of 437 red blood cell and platelet components were included and an outcome was reported for 84% of these. Just over half of identified recipients were dead at the time of lookback; blood samples for testing were obtained from 77% of identified living recipients. HTLV infection was confirmed in seven recipients, but one was discounted as not transfusion transmitted. CONCLUSION Although numbers are small, our results provide evidence of the efficacy of leukoreduction in reducing the likelihood of HTLV transmission through transfusion of cellular blood components. The HTLV-positive rate in recipients of leukoreduced components was 3.7%, a reduction of 93% compared with nonleukoreduced components. Importantly, the one infected recipient of a leukoreduced component had existing risk factors for HTLV infection. HTLV lookback was much less efficient in identifying infected recipients than was hepatitis virus C lookback.
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Affiliation(s)
- Patricia E Hewitt
- NHSBT, Colindale Centre, London, UK; NHSBT/HPA Epidemiology Team, Colindale, London, UK; National Centre for Human Retrovirology, St Mary's Hospital, London, UK
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13
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O'Brien SF, Zou S, Laperche S, Brant LJ, Seed CR, Kleinman SH. Surveillance of transfusion-transmissible infections comparison of systems in five developed countries. Transfus Med Rev 2011; 26:38-57. [PMID: 21944935 PMCID: PMC7134890 DOI: 10.1016/j.tmrv.2011.07.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Most industrialized countries maintain surveillance programs for monitoring transmissible infection in blood donations, revising approaches to methodology and risk assessment as new threats emerge. A comparison of programs in the United States, Canada, France, the UK, and Australia indicates that they have similar function, although the structure of blood programs vary as does the extent and nature of formal ties with public health. The emergence of HIV in the late 1970s and early 1980s was key in recognizing that surveillance systems specific to blood transfusion were essential. Hence, most industrialized countries monitor transfusion-transmissible infections in donors and evaluate the impact of new testing and of predonation screening strategies. Emerging infections since HIV have had different transmission pathways and challenged blood programs to draw upon resources for a rapid and effective response, with recognition that the original focus on sexual/drug-related risk of HIV and hepatitis was inadequate. The focus of surveillance programs on new and emerging pathogens fulfills a key role in risk assessment and policy formulation. The precise nature of such activities varies by country because of the structure of the blood programs and surveillance systems, the strategic focus of the blood programs, and the epidemiology of disease in each country.
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Affiliation(s)
- Sheila F O'Brien
- National Epidemiology and Surveillance, Canadian Blood Services, 1800 Alta Vista Drive, Ottawa, Ontario, Canada K1G 4J5. sheila.o'
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