Measures to decrease the risk of acquired immunodeficiency syndrome transmission by blood transfusion

Abstract

We studied whether volunteers giving blood to the Greater New York Blood Program (GNYBP) cooperated with procedures implementing public health recommendations intended to decrease the risk of acquired immunodeficiency syndrome (AIDS) transmission by blood transfusion. Predonation medical screening was expanded to exclude donors who might be ill with AIDS. To exclude possible asymptomatic carriers of the disease, members of groups at increased risk of AIDS were asked either not to give blood or to give it for laboratory studies. A confidential questionnaire, administered to all donors after medical screening, provided the vehicle for donors to advise the GNYBP whether their donation was for laboratory studies or for patient transfusion. We found that the number of male donors decreased; AIDS-related questions in medical history led to a 2 percent increase in donor rejections; 97 percent of donors said their blood could be used for transfusions; 1.4 percent said their blood could be used for laboratory studies only; and 1.6 percent did not respond. Only units designated for transfusion were released to hospitals. People who indicated that their donation was for laboratory studies had a higher prevalence of markers for hepatitis B virus and of antibodies to cytomegalovirus. White cell counts and helper/suppressor T lymphocyte ratios were not significantly different in the two groups. We conclude that volunteer donors have cooperated with the established procedures. None of the laboratory assays identified blood units donated by individuals who, based on information about AIDS high-risk groups, designated their donation for laboratory studies.

Positivity of HIV, hepatitis B and hepatitis C in patients enrolled in a confidential self-exclusion system of blood donation: a cross-sectional analytical study

“…3,4 Confidential self-exclusion (CSE) systems have been designed for this type of blood donor, so that high-risk donors can confidentially exclude their blood from use for transfusions. 1 The first CSE system was designed in 1984 in the United States as an option for improving blood safety, 1 and similar systems have since been used in many countries. 1 At the Fars Province Blood Transfusion Organization in Shiraz (southern Iran), a CSE system was launched in 2006.…”

“…The system has been used as an extra screening test to detect blood-borne diseases in donors who come to the donation center during their window period. 1,[5][6][7] However, earlier studies suggested that the sensitivity and positive predictive value of CSE may be low. 8 In 1992, the Food and Drug Administration (FDA) recommended that CSE should not be used.…”

Comparison of deferral rates using a computerized versus written blood donor questionnaire: a randomized, cross-over study [ISRCTN84429599]

“…Strategies to reduce the risks to blood product recipients have involved public education programs, administration of questionnaires pertaining to HIV risk factors, the use of a confidential self-exclusion (CSE) option which allows the donor to indicate in a confidential manner that their blood should not be used for transfusion, and direct questioning about risk behaviours. These strategies have been found to eliminate some high risk [1,2] and some infected units [3]. While there have been notable decreases in HIV-positive donations [4,5], some donors, who are aware of their high-risk behaviours continue to donate without self-deferral [3,6-9].…”

Reducing the risk of transfusion‐transmissible viral infection through blood donor selection: the Australian experience 2000 through 2006

“…Evaluations of donor selection processes have demonstrated the principle that careful donor selection processes reduce the prevalence of certain TTVIs in accepted blood donors compared with the general population 21‐24 . These data have been supplemented by studies of risk factors for infection of individual TTVIs (notably HIV and HCV) in various groups of accepted blood donors 25‐29 .…”