Significant numbers of T. cruzi-seropositive donors contribute to the U.S. blood supply. The incidence of seropositivity is enhanced by minority recruitment efforts necessitated by donor demographic shifts. Similarly, high rates among directed donations in Los Angeles are attributable to a disproportionate number of at-risk directed donors. Current look-back data likely underestimate the frequency of transfusion- transmitted T. cruzi. These results indicate that continued evaluation of transfusion as a mode of T. cruzi transmission in the United States is needed.
A comprehensive seroepidemiologic study was conducted in two Red Cross regions (Los Angeles and Miami) to determine the prevalence of Trypanosoma cruzi antibodies in at-risk blood donors, to identify additional risk factors, and to assess the likelihood of transmitting T. cruzi by transfusion. At-risk and control donors were stratified by a broad risk question, tested for T. cruzi antibodies, and if confirmed as seropositive, enrolled in case-control and lookback investigations. A total of 299,398 donors were queried; 23,978 at-risk and 25,587 control donations were tested, and T. cruzi antibodies were confirmed in 34 donors (33 and 1, respectively). Seropositive donors shared one risk factor; birth/extensive time in a T. cruzi-endemic area. Lookback studies identified 11 recipients, all negative for T. cruzi antibodies. Screening strategies that use a question are unlikely to identify all seropositive donors. The lack of definitive data on the risk of transmission by transfusion indicates additional studies of donors and recipients are needed.
on sera from 39,898 blood donors at ight blood centers in ographicll dict areas of the United States. Ten donors (0.025 percent) showed cvidelcc of HLV-I seropositivity by ezme immunoassays; this was firmed by protin immunuoblot and rioimmunoprecipitation. Seoevalce rates rantd from 0 to 0.10 percent at the locations sampled, with HLV-I antbodies found predominantly in donors from the southeasten and southwestern Unitd Stateb. Matched casc-control interviews and laboratory studics werc peroirmed on five seropositive women and two seropositive mcn who participated in an id -linked collection of sera from a subst of 33,893 donors at six ofthe eight blood centers. Four ofthe women and both men are black; one woman is Caca Four Ofthe sv oot inividuals admitted to prior intravenous drug abuse or sexual contact with an intravenous drug user. Sexual contact with native inhatn ofan HTLV-I endemic area was the only idene risk factor for one male. The distribltion of HTLV-I antibdies in this U.S. blood donor sample corroborates the previous reported pde i of this agent and sug that additional donor screning measures, includisg the tetng of donated bkood for HLV-I markr, may be ne to prevent the spead of HTfV-I to transfsion recipets.U.S. IV drug abusers and the unknown prevalence ofinfecton in the general population, there is increasing concem that asymiptomatic HTLV-I carriers may be present at low levels in the U.S. blood donor pool. Although all volunteer blood donors are highly screened by general health history information, specific exdusion criteria for AIDS risk factors, and laboratory tests for HIV-1 antibodies, hepatitis B surface antgen, antibodies to the hepatitis B core antigen, alanine aminotransferase (ALT), and syphilis serology, die efficacy of these measures to exdude HTLV-I carriers is unknown.
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