1
|
Nishiya AS, Salles NA, Almeida-Neto C, Lombardi SCFS, Nogueira FAH, Rocha V, Mendrone-Jr A. CONFIRMED USE OF ANTIRETROVIRAL DRUGS FOR HIV THERAPY IN TWO BLOOD DONORS WITH POTENTIAL ELITE CONTROLLER PROFILE FROM SÃO PAULO. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
2
|
Mendrone-Junior A, Dinardo CL, Ferreira SC, Nishya A, Salles NA, de Almeida Neto C, Hamasaki DT, Facincani T, de Oliveira Alves LB, Machado RRG, Araujo DB, Durigon EL, Rocha V, Sabino EC. Correlation between SARS-COV-2 antibody screening by immunoassay and neutralizing antibody testing. Transfusion 2021; 61:1181-1190. [PMID: 33491194 PMCID: PMC8013621 DOI: 10.1111/trf.16268] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/13/2020] [Accepted: 11/16/2020] [Indexed: 12/18/2022]
Abstract
Background The efficacy of convalescent plasma (CP), an alternative for the treatment of COVID‐19, depends on high titers of neutralizing antibodies (nAbs), but assays for quantifying nAbs are not widely available. Our goal was to develop a strategy to predict high titers of nAbs based on the results of anti‐SARS‐CoV‐2 immunoassays and the clinical characteristics of CP donors. Study Design and Methods A total of 214 CP donors were enrolled and tested for the presence of anti‐SARS‐CoV‐2 antibodies (IgG) using two commercial immunoassays: EUROIMMUN (ELISA) and Abbott (Chemiluminescence). Quantification of nAbs was performed using the Cytopathic Effect‐based Virus Neutralization test. Three criteria for identifying donors with nAbs ≥ 1:160 were tested: – C1: Curve ROC; − C2: Conditional decision tree considering only the IA results and – C3: Conditional decision tree including both the IA results and the clinical variables. Results The performance of the immunoassays was similar referring to both S/CO and predictive value for identifying nAbs titers ≥1:160. Regarding the studied criteria for identifying CP donors with high nAbs titers: (a) C1 showed 76.1% accuracy if S/CO = 4.65, (b) C2 presented 76.1% accuracy if S/CO ≥4.57 and (c) C3 had 71.6% accuracy if S/CO was ≥4.57 or if S/CO was between 2.68‐4.57 and the last COVID‐19‐related symptoms were recent (within 19 days). Conclusion SARS‐CoV‐2 IgG immunoassays (S/CO) can be used to predict high anti‐SARS‐CoV‐2 nAbs titers. This study has proposed different criteria for identifying donors with ≥1:160 nAbs titers, all with high efficacy.
Collapse
Affiliation(s)
- Alfredo Mendrone-Junior
- undação Pro Sangue Hemocentro de São Paulo, São Paulo, Brazil.,Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology (LIM-31) HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Carla Luana Dinardo
- undação Pro Sangue Hemocentro de São Paulo, São Paulo, Brazil.,Instituto de Medicina Tropical, FMUSP, São Paulo, Brazil
| | | | - Anna Nishya
- undação Pro Sangue Hemocentro de São Paulo, São Paulo, Brazil
| | | | | | | | - Tila Facincani
- undação Pro Sangue Hemocentro de São Paulo, São Paulo, Brazil
| | | | | | - Danielle Bastos Araujo
- Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Edison Luiz Durigon
- Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil.,Scientific Platform Pasteur USP, São Paulo, Brazil
| | - Vanderson Rocha
- undação Pro Sangue Hemocentro de São Paulo, São Paulo, Brazil.,Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology (LIM-31) HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil.,Serviço de Hematologia, Hemoterapia e Terapia Celular - HCFMUSP, São Paulo, Brazil
| | | |
Collapse
|
3
|
Attie A, de Almeida-Neto C, S Witkin S, Derriga J, Nishiya AS, Ferreira JE, Costa NDSX, Alves Salles N, Facincani T, Levi JE, Sabino EC, Rocha V, Mendrone-Jr A, Ferreira SC. Detection and analysis of blood donors seropositive for syphilis. Transfus Med 2021; 31:121-128. [PMID: 33480044 DOI: 10.1111/tme.12761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/29/2020] [Accepted: 01/02/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The increasing incidence of syphilis worldwide has called attention to the risk of transmission by transfusion. AIMS To determine the prevalence of active syphilis in blood donors and characterise the serological profile of syphilis-positive donors. METHODS Samples positive for Treponema pallidum using the chemiluminescent microparticle immunoassay (CMIA) during blood donor screening from 2017 to 2018 were tested by the Venereal Disease Research Laboratory (VDRL) non-treponemal test and for anti-T. pallidum IgM by ELISA (Immunoassay Enzyme test for detection of IgM antibodies). The INNO-LIA Syphilis test (Line Immuno Assay solid test for confirmation antibodies to Treponema pallidum) was performed as a confirmatory test on samples that were positive on ELISA-IgM but negative on VDRL. ELISA-IgM (+) samples were also tested for T. pallidum DNA in sera by real-time polymerase chain reaction (PCR). RESULTS Of 248 542 samples screened, 1679 (0.67%) were positive for syphilis by CMIA. Further analysis was performed on 1144 (68.1%) of these samples. Of those tested, 16% were ELISA IgM(+)/VDRL(+), 16.5% were ELISA IgM(-)/VDRL(+), 4.1% were ELISA IgM(+)/VDRL(-), and 63.4% were ELISA IgM (-)/VDRL(-). The INNO-LIA Syphilis test results were 33 (3%) positive, 2 (0.2%) undetermined and 12 (1%) negative. Of the 230 EIA-IgM(+) samples (20.1%), 5 (2.2%) were PCR positive. The prevalence of active syphilis in 2017 and 2018 was 0.1% and 0.07%, respectively, and overall prevalence of serologic markers for syphilis was highest among male, unmarried, 25-34-year-olds with a high school education and who were first-time donors. CONCLUSION There is a risk of transfusion-transmitted syphilis in blood banks that exclusively use the VDRL test for donor screening, as is currently the situation in some Brazilian blood centres, as well as in other blood centres around the world.
Collapse
Affiliation(s)
- Adriana Attie
- Divisão de Pesquisa & Medicina Transfusional, Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil
| | - Cesar de Almeida-Neto
- Divisão de Pesquisa & Medicina Transfusional, Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil.,Disciplina de Ciências Médicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Steven S Witkin
- Laboratorio de Investigação Medica em Virologia (LIM 52), Instituto de Medicina Tropical da Universidade de São Paulo, São Paulo, Brazil.,Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, New York, USA
| | - Juliana Derriga
- Divisão de Pesquisa & Medicina Transfusional, Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil
| | - Anna S Nishiya
- Divisão de Pesquisa & Medicina Transfusional, Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil.,Laboratory of Medical Investigation in Pathogenesis and Targeted Therapy in Onco-Immuno-Hematology (LIM-31), Department of Hematology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Jerenice E Ferreira
- Laboratorio de Investigação Medica em Virologia (LIM 52), Instituto de Medicina Tropical da Universidade de São Paulo, São Paulo, Brazil.,Centro de Patologia, Instituto Adolf Lutz, São Paulo, Brazil
| | | | - Nanci Alves Salles
- Divisão de Pesquisa & Medicina Transfusional, Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil
| | - Tila Facincani
- Divisão de Pesquisa & Medicina Transfusional, Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil
| | - Jose E Levi
- Laboratorio de Investigação Medica em Virologia (LIM 52), Instituto de Medicina Tropical da Universidade de São Paulo, São Paulo, Brazil
| | - Ester C Sabino
- Disciplina de Ciências Médicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Vanderson Rocha
- Divisão de Pesquisa & Medicina Transfusional, Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil.,Disciplina de Ciências Médicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Medical Investigation in Pathogenesis and Targeted Therapy in Onco-Immuno-Hematology (LIM-31), Department of Hematology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Alfredo Mendrone-Jr
- Divisão de Pesquisa & Medicina Transfusional, Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil.,Laboratory of Medical Investigation in Pathogenesis and Targeted Therapy in Onco-Immuno-Hematology (LIM-31), Department of Hematology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Suzete C Ferreira
- Divisão de Pesquisa & Medicina Transfusional, Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil.,Laboratory of Medical Investigation in Pathogenesis and Targeted Therapy in Onco-Immuno-Hematology (LIM-31), Department of Hematology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| |
Collapse
|
4
|
Salles NA, Nishiya AS, Ferreira SC, Rocha VG, Mendrone-Junior A. Detection of HIV-1 infections in blood donors during the pre-seroconversion window period in São Paulo, Brazil. Rev Soc Bras Med Trop 2019; 52:e20180432. [DOI: 10.1590/0037-8682-0432-2018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 03/27/2019] [Indexed: 11/22/2022] Open
|
5
|
Truong HHM, Blatyta PF, Santos FM, Montebello S, Esposti SPD, Hangai FN, Salles NA, Mendrone A, Sabino EC, McFarland W, Gonçalez TT. Blood Donor Test-Seeking Motivation and Prior HIV Testing Experiences in São Paulo, Brazil. AIDS Behav 2015; 19:1574-8. [PMID: 25795320 PMCID: PMC4553114 DOI: 10.1007/s10461-015-1036-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
HIV test-seeking behavior among blood donors has been observed worldwide and may pose a threat to the safety of the blood supply. We evaluated current test-seeking motivations and prior alternative HIV testing experiences among blood donors in São Paulo, Brazil. All candidate or potential blood donors were consecutively approached and recruited to participate in the study upon presentation at Fundação Pró-Sangue Hemocentro, the largest blood bank in Brazil. Participants were recruited between August 2012 and May 2013 after they were screened for donor eligibility. Questionnaires were administered through audio computer-assisted self-interview. Among 11,867 donors, 38 % previously tested for HIV apart from blood donation, of whom 47.7 % tested at public facilities and 2.7 % acknowledged getting tested for HIV as the primary reason for donating. Dissatisfaction with prior alternative testing experience was reported by 2.5 % of donors. Current test-seeking motivation was associated with dissatisfaction with prior alternative testing experience and testing at a public alternative facility. The most common reasons for dissatisfaction were too long of a wait to get tested and for results, counseling was too long, lack of privacy, and low confidence in the equipment and accuracy of the test. Lack of awareness about the availability of free and confidential public HIV testing services as well as dissatisfaction with past HIV testing and counseling experiences motivate some individuals to test at blood banks. Test-seeking behavior among blood donors may be best addressed by improving alternative testing programs, particularly with respect to time delays, privacy and perceptions about test accuracy. Educational campaigns on safe blood donation and HIV testing for diagnosis, risk counseling and referral to care are also needed for the general public and for health care providers.
Collapse
Affiliation(s)
- Hong-Ha M Truong
- University of California, San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA, 94158, USA,
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Nishiya AS, Almeida-Neto CD, Romano CM, Alencar CS, Ferreira SC, Di-Lorenzo-Oliveira C, Levi JE, Salles NA, Mendrone-Junior A, Sabino EC. Phylogenetic analysis of the emergence of main hepatitis C virus subtypes in São Paulo, Brazil. Braz J Infect Dis 2015; 19:473-8. [PMID: 26296325 PMCID: PMC9427527 DOI: 10.1016/j.bjid.2015.06.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 04/10/2015] [Accepted: 06/14/2015] [Indexed: 01/04/2023] Open
Abstract
Background It is recognized that hepatitis C virus subtypes (1a, 1b, 2a, 2b, 2c and 3a) originated in Africa and Asia and spread worldwide exponentially during the Second World War (1940) through the transfusion of contaminated blood products, invasive medical and dental procedures, and intravenous drug use. The entry of hepatitis C virus subtypes into different regions occurred at distinct times, presenting exponential growth rates of larger or smaller spread. Our study estimated the growth and spread of the most prevalent subtypes currently circulating in São Paulo. Methods A total of 465 non-structural region 5B sequences of hepatitis C virus covering a 14-year time-span were used to reconstruct the population history and estimate the population dynamics and Time to Most Recent Common Ancestor of genotypes using the Bayesian Markov Chain Monte Carlo approach implemented in BEAST (Bayesian evolutionary analysis by sampling tree software/program). Results Evolutionary analysis demonstrated that the different hepatitis C virus subtypes had distinct growth patterns. The introduction of hepatitis C virus-1a and -3a were estimated to be circa 1979 and 1967, respectively, whereas hepatitis C virus-1b appears to have a more ancient entry, circa 1923. Hepatitis C virus-1b phylogenies suggest that different lineages circulate in São Paulo, and four well-supported groups (i.e., G1, G2, G3 and G4) were identified. Hepatitis C virus-1a presented the highest growth rate (r = 0.4), but its spread became less marked after the 2000s. Hepatitis C virus-3a grew exponentially until the 1990s and had an intermediate growth rate (r = 0.32). An evident exponential growth (r = 0.26) was found for hepatitis C virus-1b between 1980 and the mid-1990s. Conclusions After an initial period of exponential growth, the expansion of the three main subtypes began to decrease. Hepatitis C virus-1b presented inflated genetic diversity, and its transmission may have been sustained by different generations and transmission routes other than blood transfusion. Hepatitis C virus-1a and -3a showed no group stratification, most likely due to their recent entry.
Collapse
Affiliation(s)
- Anna Shoko Nishiya
- Fundação Pró-Sangue/Hemocentro de São Paulo, São Paulo, SP, Brazil; Infectious Diseases Division (DIPA), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
| | - César de Almeida-Neto
- Fundação Pró-Sangue/Hemocentro de São Paulo, São Paulo, SP, Brazil; Discipline of Medical Science, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Camila Malta Romano
- Laboratory of Virology, Department of Infectious and Parasitic Diseases, Instituto de Medicina Tropical de São Paulo, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Cecília Salete Alencar
- Infectious Diseases Division (DIPA), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil; Lim 03 Medical Research Laboratory, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Suzete Cleusa Ferreira
- Fundação Pró-Sangue/Hemocentro de São Paulo, São Paulo, SP, Brazil; Infectious Diseases Division (DIPA), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | | | | | | | | | - Ester Cerdeira Sabino
- Infectious Diseases Division (DIPA), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil; Department of Infectious Disease, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| |
Collapse
|
7
|
Levi JE, Nishiya A, Félix AC, Salles NA, Sampaio LR, Hangai F, Sabino EC, Mendrone A. Real-time symptomatic case of transfusion-transmitted dengue. Transfusion 2015; 55:961-4. [PMID: 25605570 DOI: 10.1111/trf.12944] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 09/11/2014] [Accepted: 09/20/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Dengue virus transmission by blood transfusion is a rarely reported event. CASE REPORT During a dengue outbreak in São Paulo city, a regular plateletpheresis donor informed the blood bank of being diagnosed a few days after donation. The recipient was hospitalized and displayed symptoms and laboratory evidence of dengue after transfusion. RESULTS The donor was immunoglobulin (Ig)G, IgM, and polymerase chain reaction nonreactive on the index sample, seroconverting 20 days later. The platelet units were transfused into two patients. One of them developed fever 3 days after transfusion, with high viral load. His pretransfusion sample was negative for IgG, IgM, and dengue RNA, while the second recipient did not show any symptoms nor laboratory evidence of dengue infection. CONCLUSIONS This case brings additional evidence that dengue is indeed transmissible by blood transfusion and clinical manifestations, although rare, do occur.
Collapse
Affiliation(s)
- José Eduardo Levi
- Fundação Pró-Sangue, Hemocentro de São Paulo, University of São Paulo, São Paulo, Brazil.,Virology Lab, Instituto de Medicina Tropical da Universidade de São Paulo, University of São Paulo, São Paulo, Brazil
| | - Anna Nishiya
- Fundação Pró-Sangue, Hemocentro de São Paulo, University of São Paulo, São Paulo, Brazil
| | - Alvina Clara Félix
- Virology Lab, Instituto de Medicina Tropical da Universidade de São Paulo, University of São Paulo, São Paulo, Brazil
| | - Nanci Alves Salles
- Fundação Pró-Sangue, Hemocentro de São Paulo, University of São Paulo, São Paulo, Brazil
| | | | - Fátima Hangai
- Fundação Pró-Sangue, Hemocentro de São Paulo, University of São Paulo, São Paulo, Brazil
| | - Ester Cerdeira Sabino
- Department of Infectious and Parasitic Diseases, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Alfredo Mendrone
- Fundação Pró-Sangue, Hemocentro de São Paulo, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
8
|
Loureiro P, de Almeida-Neto C, Proietti ABC, Capuani L, Gonçalez TT, de Oliveira CDL, Leão SC, Lopes MI, Sampaio D, Patavino GM, Ferreira JE, Blatyta PF, Duarte Lopes ME, Mendrone-Junior A, Salles NA, King M, Murphy E, Busch M, Custer B, Sabino EC. [Not Available]. Rev Bras Hematol Hemoter 2014; 36:152-8. [PMID: 24790542 PMCID: PMC4005515 DOI: 10.5581/1516-8484.20140033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 11/26/2013] [Indexed: 11/27/2022] Open
Abstract
The Retrovirus Epidemiology Donor Study (REDS) program was established in the United States in 1989 with the purpose of increasing blood transfusion safety in the context of the HIV/AIDS and human T-lymphotropic virus epidemics. REDS and its successor, REDS-II were at first conducted in the US, then expanded in 2006 to include international partnerships with Brazil and China. In 2011, a third wave of REDS renamed the Recipient Epidemiology and Donor Evaluation Study-III (REDS-III) was launched. This seven-year research program focuses on both blood banking and transfusion medicine research in the United States of America, Brazil, China, and South Africa. The main goal of the international programs is to reduce and prevent the transmission of HIV/AIDS and other known and emerging infectious agents through transfusion, and to address research questions aimed at understanding global issues related to the availability of safe blood. This article describes the contribution of REDS-II to transfusion safety in Brazil. Articles published from 2010 to 2013 are summarized, including database analyses to characterize blood donors, deferral rates, and prevalence, incidence and residual risk of the main blood-borne infections. Specific studies were developed to understand donor motivation, the impact of the deferral questions, risk factors and molecular surveillance among HIV-positive donors, and the natural history of Chagas disease. The purpose of this review is to disseminate the acquired knowledge and briefly summarize the findings of the REDS-II studies conducted in Brazil as well as to introduce the scope of the REDS-III program that is now in progress and will continue through 2018. © 2014 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. All rights reserved.
Collapse
Affiliation(s)
- Paula Loureiro
- Faculdade de Ciências Médicas, Universidade de Pernambuco (UPE), Recife, PE, Brazil; Fundação Hemope, Recife, PE, Brazil
| | | | | | - Ligia Capuani
- Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | | | | | | | | | - Divaldo Sampaio
- Faculdade de Ciências Médicas, Universidade de Pernambuco (UPE), Recife, PE, Brazil; Fundação Hemope, Recife, PE, Brazil
| | | | - João Eduardo Ferreira
- Instituto de Matemática e Estatística, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | | | | | | | | | | | - Edward Murphy
- University of California San Francisco, California, USA
| | - Michael Busch
- Blood System Research Institute, San Francisco, California, USA
| | - Brian Custer
- Blood System Research Institute, San Francisco, California, USA
| | | |
Collapse
|
9
|
Ferreira SC, de Almeida-Neto C, Nishiya AS, Oliveira CDL, Ferreira JE, Alencar CS, Levi JE, Salles NA, Mendrone A, Sabino EC. Demographic, risk factors and motivations among blood donors with reactive serologic tests for syphilis in São Paulo, Brazil. Transfus Med 2014; 24:169-75. [PMID: 24779667 DOI: 10.1111/tme.12124] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 02/12/2014] [Accepted: 04/07/2014] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To identify the demographic characteristics, risk factors and motivations for donating among blood donors with reactive serologic tests for syphilis. BACKGROUND Post-donation interviews with syphilis seropositive blood donors improve recruitment and screening strategies. METHODS This case-control study compares 75 Venereal Disease Research Laboratory (VDRL) > 8, EIA+ (enzyme immunoassay) and FTA-ABS+ (fluorescent treponemal antibody); 80 VDRL-, EIA+ and FTA-ABS+; and 34 VDRL- and EIA- donors between 2004 and 2009. Donors were assessed by their demographic characteristics, sexual behaviour, history of alcohol and illicit drugs use, and motivations to donate. RESULTS Donors with VDRL > 8 were more likely to be divorced [AOR = 12·53; 95% confidence interval (CI) 1·30-120·81], to have had more than six sexual partners (AOR=7·1; 95% CI 1·12-44·62) and to report male-male-sex in the past 12 months (AOR=8·18; 95% CI 1·78-37·60). Donors with VDRL-, EIA+ and FTA-ABS+ were less likely to be female (AOR=0·26; 95% CI 0·07-0·96), more likely to be older (AOR=10·2; 95% CI 2·45-42·58 ≥ 39 and <60 years old) and to have had more than six sexual partners in the past 12 months (AOR = 8·37; 95% CI 1·49-46·91). There was no significant difference among groups regarding illicit drugs use; 30·7% (VDRL > 8) and 12·5% (VDRL-, EIA+ and FTA-ABS+) of donors reported that they had been at risk for HIV infection (P = 0·004). One-third of donors came to the blood bank to help a friend or a relative who needed blood. CONCLUSION Although donors exposed to syphilis reported and recognised some high risk behaviour, most were motivated by direct appeal to donate blood. Monitoring the risk profile of blood donors can benefit public health and improve blood safety.
Collapse
Affiliation(s)
- S C Ferreira
- Infectious Diseases Division, Federal University of São Paulo; Department of Molecular Biology, Fundação Pró-Sangue Hemocentro de São Paulo
| | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Salles NA, Levi JE, Barreto CC, Sampaio LP, Romano CM, Sabino EC, Júnior AM. Human immunodeficiency virus transfusion transmission despite nucleic acid testing. Transfusion 2013; 53:2593-5. [PMID: 24099406 DOI: 10.1111/trf.12316] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
11
|
de Almeida-Neto C, Sabino EC, Liu J, Blatyta PF, Mendrone-Junior A, Salles NA, Leão SC, Wright DJ, Basques FV, Ferreira JE, Busch MP, Murphy EL. 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. Transfusion 2012; 53:827-34. [PMID: 22882510 DOI: 10.1111/j.1537-2995.2012.03840.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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.
Collapse
|
12
|
Gonçalez TT, Sabino EC, Salles NA, de Almeida-Neto C, Mendrone A, Dorlhiac-Laccer PE, Liu J, Murphy EL, Schreiber GB. The impact of simple donor education on donor behavioral deferral and infectious disease rates in São Paulo, Brazil. Transfusion 2009; 50:909-17. [PMID: 20003056 DOI: 10.1111/j.1537-2995.2009.02526.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Studies have shown that human immunodeficiency virus (HIV) residual risk is higher in Brazilian than in US and European blood donors, probably due to failure to defer at-risk individuals in Brazil. This study assessed the impact of an educational brochure in enhancing blood donors' knowledge about screening test window phase and reducing at-risk individuals from donating. STUDY DESIGN AND METHODS This trial compared an educational intervention with a blood center's usual practice. The brochure was distributed in alternating months to all donors. After donating, sampled participants completed two questions about their HIV window period knowledge. The impact on HIV risk deferral, leaving without donation, confidential unit exclusion (CUE) use, and test positivity was also analyzed. RESULTS From August to November 2007 we evaluated 33,940 donations in the main collection center of Fundação Pró-Sangue/Hemocentro de São Paulo in São Paulo, Brazil. A significant (p < 0.001) pamphlet effect was found on correct responses to both questions assessing HIV window phase knowledge (68.1% vs. 52.9%) and transfusion risk (91.1% vs. 87.2%). After adjusting for sex and age, the pamphlet effect was strongest for people with more than 8 years of education. There was no significant pamphlet effect on HIV risk deferral rate, leaving without donation, use of CUE, or infectious disease rates. CONCLUSION While the educational pamphlet increased window period knowledge, contrary to expectations this information alone was not enough to make donors self-defer or acknowledge their behavioral risk.
Collapse
Affiliation(s)
- Thelma T Gonçalez
- Blood Systems Research Institute, 270, Masonic Avenue, San Francisco, CA 94118, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Goncalez TT, Sabino EC, Chen S, Salles NA, Chamone DAF, McFarland W, Murphy EL. Knowledge, attitudes and motivations among blood donors in São Paulo, Brazil. AIDS Behav 2008; 12:S39-47. [PMID: 18389356 DOI: 10.1007/s10461-008-9391-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2007] [Accepted: 03/20/2008] [Indexed: 11/25/2022]
Abstract
Recruiting safe, volunteer blood donors requires understanding motivations for donating and knowledge and attitudes about HIV. We surveyed 1,600 persons presenting for blood donation at a large blood bank in São Paulo, Brazil using a self-administered, structured questionnaire, and classified motivations into three domains as well as categorizing persons by HIV test-seeking behavior. Motivations, in descending order, and their significant associations were: "altruism": female gender, volunteer donor and repeat donor status; "direct appeal": female gender, repeat donor status and age 21-50 years; "self-interest": male gender, age under 20 years, first-time donor status and lower education. HIV test-seekers were more likely to give incorrect answers regarding HIV risk behavior and blood donation and the ability of antibody testing to detect recent HIV infections. Altruism is the main motivator for blood donation in Brazil; other motivators were associated with specific demographic subgroups. HIV test-seeking might be reduced by educational interventions.
Collapse
|
14
|
Barreto AMEC, Takei K, E C S, Bellesa MAO, Salles NA, Barreto CC, Nishiya AS, Chamone DF. Cost-effective analysis of different algorithms for the diagnosis of hepatitis C virus infection. ACTA ACUST UNITED AC 2008; 41:126-34. [PMID: 18235967 DOI: 10.1590/s0100-879x2008005000004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2007] [Accepted: 11/26/2007] [Indexed: 11/21/2022]
Abstract
We compared the cost-benefit of two algorithms, recently proposed by the Centers for Disease Control and Prevention, USA, with the conventional one, the most appropriate for the diagnosis of hepatitis C virus (HCV) infection in the Brazilian population. Serum samples were obtained from 517 ELISA-positive or -inconclusive blood donors who had returned to Fundação Pró-Sangue/Hemocentro de São Paulo to confirm previous results. Algorithm A was based on signal-to-cut-off (s/co) ratio of ELISA anti-HCV samples that show s/co ratio > or =95% concordance with immunoblot (IB) positivity. For algorithm B, reflex nucleic acid amplification testing by PCR was required for ELISA-positive or -inconclusive samples and IB for PCR-negative samples. For algorithm C, all positive or inconclusive ELISA samples were submitted to IB. We observed a similar rate of positive results with the three algorithms: 287, 287, and 285 for A, B, and C, respectively, and 283 were concordant with one another. Indeterminate results from algorithms A and C were elucidated by PCR (expanded algorithm) which detected two more positive samples. The estimated cost of algorithms A and B was US$21,299.39 and US$32,397.40, respectively, which were 43.5 and 14.0% more economic than C (US$37,673.79). The cost can vary according to the technique used. We conclude that both algorithms A and B are suitable for diagnosing HCV infection in the Brazilian population. Furthermore, algorithm A is the more practical and economical one since it requires supplemental tests for only 54% of the samples. Algorithm B provides early information about the presence of viremia.
Collapse
Affiliation(s)
- A M E C Barreto
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Ciências Farmacêuticas, Universidade de São Paulo, São Paulo, SP, Brasil.
| | | | | | | | | | | | | | | |
Collapse
|
15
|
Scuracchio PSP, Poli MCC, Lemos MMM, Oliveira Filho AG, Salles NA, Chamone DAF, Magri M, Cavalcante NJF, Collela R. Detection of HIV-1 infection in blood donors during the immunological window period using the nucleic acid-amplification technology. Transfus Med 2007; 17:200-4. [PMID: 17561863 DOI: 10.1111/j.1365-3148.2007.00748.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Individual nucleic acid-amplification testing (NAT) was recently recommended by Brazilian legislation and has been implemented at some blood banks in the city of São Paulo, Brazil, in an attempt to reduce the transfusion transmission of human immunodeficiency virus (HIV) and hepatitis C viruses. This screening test can identify donations made during the immunological window period before seroconversion. The impact of this technology in our blood donors and transfusion routine was studied. In all, 47 866 donations were tested from March 2004 until November 2005, according to Brazilian legislation, using two approved enzyme immunoassays for HIV antibodies and individual NAT. Supplemental tests included Western blot, p24 antigen detection and quantitative PCR-HIV-1. Among the donors screened, two (one first-time and one repeat donor) were non-reactive in enzyme immunoassays, with negative confirmatory p24 antigen and Western blot, but positive for HIV-1 NAT. Although serological analysis for HIV is a primary tool for diagnostic testing, the addition of NAT allowed for identification and prevention of component transfusion from two HIV-positive blood donations during an 18-month period. The screening of donors reduced the immunological window period, permitting the identification of very early stage HIV infections. In addition, this report also emphasized the fact that the risk of HIV transmission is not limited to the first-time donors.
Collapse
|
16
|
de Almeida Neto C, McFarland W, Murphy EL, Chen S, Nogueira FAH, Mendrone A, Salles NA, Chamone DAF, Sabino EC. Risk factors for human immunodeficiency virus infection among blood donors in Sao Paulo, Brazil, and their relevance to current donor deferral criteria. Transfusion 2007; 47:608-14. [PMID: 17381618 DOI: 10.1111/j.1537-2995.2007.01161.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The objective of this study was to investigate risk factors of human immunodeficiency virus (HIV)-seropositive blood donors in Brazil and to determine if current donor deferral criteria are appropriate. STUDY DESIGN AND METHODS Demographic and behavioral data among cases with confirmed HIV seropositivity (n = 272) were compared with those who had a false-positive serology (n = 468) between January 1999 and December 2003 in a case-control analysis with logistic regression. RESULTS Risk factors that should have resulted in predonation deferral were reported by 48.9 percent of HIV-positive and 9.4 percent of false-positive donors. In multivariate analysis, male cases were significantly more likely to report male-male sex (adjusted odds ratio [AOR], 26.2; 95% confidence interval [CI], 7.8-87.4), a previous sexually transmitted disease diagnosis (AOR, 3.2; 95% CI, 1.5-6.9), exchanging money for sex (AOR, 2.1; 95% CI, 1.0-4.2), and at least two partners in the past 12 months (AOR, 2.3; 95% CI, 1.4-3.6). HIV-positive male donors were also more likely to be reactive for the presence of hepatitis C virus antibody (AOR, 4.0; 95% CI, 1.3-12.0) and hepatitis B virus core antibody (AOR, 3.8; 95% CI, 1.9-7.7). Female cases were more likely to report an intravenous drug user partner (AOR, 12.4; 95% CI, 1.3-120.2), a sexual partner with multiple sex partners or who had a history of sex with a sex worker (AOR, 13.0; 95% CI, 2.7-63.2), and at least two partners in the past 12 months (AOR, 2.2; 95% CI, 1.0-5.3). CONCLUSION A substantial number of HIV-infected donors reported a risk factor that could have been identified in the predonation screening. Male-male sexual behavior was still the strongest determinant of HIV status in the studied population.
Collapse
|
17
|
Poli MCC, Colella R, Dourado DA, Murad Y, Simpson C, Salles NA. [The importance of PCR in hepatitis C for blood donors triage]. Rev Assoc Med Bras (1992) 2003; 49:242-3. [PMID: 14671743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
|
18
|
Salles NA, Sabino EC, Cliquet MG, Eluf-Neto J, Mayer A, Almeida-Neto C, Mendonça MC, Dorliach-Llacer P, Chamone DF, Saéz-Alquézar A. Risk of exposure to Chagas' disease among seroreactive Brazilian blood donors. Transfusion 1996; 36:969-73. [PMID: 8937406 DOI: 10.1046/j.1537-2995.1996.36111297091740.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Screening of blood donors for Chagas' disease by using currently available serologic tests is complicated by the lack of adequate sensitivity, discordant results between tests, and the absence of a gold standard. STUDY DESIGN AND METHODS The study was designed to evaluate the serologic tests by using epidemiologic data relating to the risk of exposure to Trypanosoma cruzi in the urban centers of Brazil. The serologic results obtained from screening 411,617 voluntary blood donations in São Paulo during 1993 and 1994 were reviewed, as well as follow-up results on 1,267 donors who initially were repeatably reactive in at least one of three screening tests. Epidemiologic data were obtained from 321 individuals who on follow-up remained reactive in at least one test and who returned for medical counseling. Controls included 119 screen-negative blood donors and 45 blood donors who were repeatably reactive in at least one screening test but were negative on follow-up. RESULTS Of the individuals who reacted in three screening tests, 94.6 percent remained reactive on follow-up. Of the individuals who were repeatably reactive in only one screening test, 70.8 percent were negative in all three tests on follow-up. Most individuals who reacted in two or three tests on follow-up had epidemiologic evidence of a risk of exposure to Chagas' disease. A significant proportion (29.1%) of those who were reactive in only one test on follow-up had epidemiologic evidence of exposure to the Chagas' disease vector as compared to 14.6 percent of controls (p = 0.007). This suggests that some of these individuals truly were infected. CONCLUSION No single test for Chagas' disease is sufficiently sensitive to prevent transfusion transmission of the disease in the urban centers of Brazil.
Collapse
Affiliation(s)
- N A Salles
- Fundação Pró-Sangue Hemocentro de São Paulo, Brazil
| | | | | | | | | | | | | | | | | | | |
Collapse
|