Detection of HIV-1 infections in blood donors during the pre-seroconversion window period in São Paulo, Brazil

Salles, Nanci Alves; Nishiya, Anna S.; Ferreira, Suzete Cleusa; Rocha, Vanderson; Mendrone‐Júnior, Alfredo

doi:10.1590/0037-8682-0432-2018

Cited by 4 publications

(4 citation statements)

References 11 publications

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“…Using molecular testing, we reported a high frequency of HIV, HBV and HCV in blood donors approved for blood donation by the routine screening process in two blood banks. For HIV and HCV, this escape from the serological screening process may be linked to the diagnostic window period as explored in several studies [ 24 , 25 ]. For HBV, beyond the window period, the non-detection of surface antigen (HBsAg) may be linked to occult Hepatitis B infections [ 26 – 28 ].…”

Section: Discussionmentioning

confidence: 99%

Nucleic acid testing identifies high prevalence of blood borne viruses among approved blood donors in Mozambique

et al. 2022

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Background Although blood transfusion is an intervention that saves lives, it poses significant risks to the blood receivers, including the transmission of bloodborne pathogens. We aimed at determining the prevalence of Human Immunodeficiency Virus (HIV), Hepatitis B virus (HBV), and Hepatitis C virus (HCV) in candidates approved for blood donation, and in samples considered to be negative in reference blood banks in Mozambique. Methods A cross-sectional study was performed between November 2014 and October 2015 in Maputo and Beira cities. Demographic information was obtained from all consenting blood donors using a structured questionnaire. Plasma samples were screened for HIVAb/Ag combinations, HBsAg and Anti-HCV. Blood donors considered to be negative by serological testing were re-tested in pools of six plasma samples using nucleic acid testing (NAT). Results Most blood donors were male 2,320 (83.4%) with an age range of 18 to 34 years. The overall seroprevalence of HIV, HBV and HCV infections among blood donors approved for donation was 4.6% (127; 95% CI 3.8–5.4), 4.5% (124; 95% CI 3.7–5.3) and 0.4% (11; 95% CI 0.2–0.7), respectively. The overall frequency by NAT of HIV RNA, HBV DNA, and HCV RNA in serologically negative blood donor samples was 2.6 per 1000 blood donors (7; 95% CI 1.1–5.4); 12.5 per 1000 blood donors (33; 95% CI 8.6–17.5) and 2.6 per 1000 blood donors (6; 95% CI 1.0–5.7), respectively. Conclusion Our results show high seroprevalence of HIV and HBV infections in blood donors approved for donation, and high frequency of molecular biomarkers of HIV, HBV, and HCV in blood considered to be safe. These results suggest the need for a new blood screening policy in Mozambique, including the use of NAT to detect infectious blood donations during the immunologically negative window.

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Section: Discussionmentioning

confidence: 99%

Nucleic acid testing identifies high prevalence of blood borne viruses among approved blood donors in Mozambique

et al. 2022

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“…At FPS-HSP, NAT for HIV and HCV started in 2011, two years before it became mandatory in the country. Donations during this window period revealed an HIV NAT positivity rate of 3.60 per 1,000,000 donations between 2011 and 2020 [ 22 ] that further prevented transfusion-transmitted HIV [ 31 ].…”

Section: Donor Hiv Nucleic Acid Testing (Nat)mentioning

confidence: 99%

Transfusion-Acquired HIV: History, Evolution of Screening Tests, and Current Challenges of Unreported Antiretroviral Drug Use in Brazil

Nishiya

Ferreira

Salles

et al. 2022

Viruses

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Prevention of HIV acquisition by blood transfusion from its emergence to the present day is reviewed, and current challenges are delineated. The experience of Fundação Pró-Sangue/Hemocentro de São Paulo, Brazil, is highlighted in the quest for improvements in blood safety and the evolution of increasingly sensitive and specific screening tests. Concerns and establishing stringent criteria in the screening of potential blood donors are emphasized, and the current criteria for identifying and deferring candidates at high risk of acquiring sexually transmitted diseases are summarized. Future challenges relate to the identification of donors with unreported use of antiretroviral drugs for prophylaxis against possible HIV exposure or for treatment of an HIV infection whose viral expression is undetectable by current analyses. There is a need to better understand the motivation of HIV-exposed donors and to educate them about the risk of transfusion-mediated HIV transmission despite having low or undetectable viral loads. In situations in which traditional HIV RNA or antibody detection assays remain negative, more sensitive analyses are needed to identify potential donors at risk for HIV transmission.

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“…In our center, one of the largest blood banks in Latin America, approximately 110,000 units of blood are collected annually from non‐remunerate volunteer donors. In 2020, 2% of donated blood was discarded following infectious disease screening, with 0.11% due to the detection of HIV‐related biomarkers 20 . The objective of the present study was to determine the frequency of undeclared ARV drug use in blood donations reactive for HIV markers by direct testing for ARV drugs.…”

Section: Introductionmentioning

confidence: 99%

“…In 2020, 2% of donated blood was discarded following infectious disease screening, with 0.11% due to the detection of HIV-related biomarkers. 20 The objective of the present study was to determine the frequency of undeclared ARV drug use in blood donations reactive for HIV markers by direct testing for ARV drugs.…”

Section: Introductionmentioning

confidence: 99%

Detection of unreported usage of the antiretroviral drug lamivudine in two blood donors

Nishiya,

Salles,

de Almeida‐Neto

et al. 2023

Transfusion

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BackgroundUnreported HIV antiretroviral (ARV) drug usage by blood donors compromises the ability to detect evidence of HIV infection in blood screening tests and represents a risk for blood transfusion safety. Our objective was to determine the frequency of undeclared ARV drug use by blood donors with altered HIV markers.Study Design and MethodsThis was a retrospective cross‐sectional analysis of donations that were tested for HIV antibody (ab), antigen (ag), and RNA by chemiluminescent immunoassay and nucleic acid screening tests. Positive samples were retested and were subjected to ARV drug testing by high‐performance liquid chromatography–tandem mass spectrometry.ResultsOf 345,252 blood donations, 361 (0.1%) were positive on initial testing. Samples from 296 (81.9%) of these donations were available for further analysis. The presence of HIV ab/ag and/or RNA was confirmed in 83 (28.0%) of these samples. All 296 bloods were subjected to ARV testing. The ARV drug lamivudine, at 11.3 and 6.7 ng/mL, was detected in 2 of 83 (2.4%) donations that were HIV positive. Other drugs were not detected.ConclusionUnreported ARV usage was identified in two candidates for blood donation. More intensive efforts to educate donors about disclosure and to investigate the extent of this phenomenon in Brazil are needed.

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Detection of HIV-1 infections in blood donors during the pre-seroconversion window period in São Paulo, Brazil

Cited by 4 publications

References 11 publications

Nucleic acid testing identifies high prevalence of blood borne viruses among approved blood donors in Mozambique

Nucleic acid testing identifies high prevalence of blood borne viruses among approved blood donors in Mozambique

Transfusion-Acquired HIV: History, Evolution of Screening Tests, and Current Challenges of Unreported Antiretroviral Drug Use in Brazil

Detection of unreported usage of the antiretroviral drug lamivudine in two blood donors

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