Evidence of HIV pre-exposure or post-exposure prophylaxis (PrEP/PEP) among blood donors: a pilot study, England June 2018 to July 2019

Abstract

ObjectiveDue to increased use of pre-exposure prohylaxis (PrEP) and its potential to affect HIV screening of blood donors, we undertook antiretroviral residual testing among HIV-negative male donors in England.MethodsResidual plasma samples were obtainnd from 46 male donors confirmed positive for syphilis and 96 donors who were repeat reactive for HIV antibodies in screening but confirmed as HIV-negative by reference testing. These were tested for concentrations of tenofovir and emtricitabine by high-performance liquid chromatograhpy coupled with mass spectrometry.ResultsWe found evidence of pre-exposure or post-exposure prophylaxis (PrEP/PEP) use in three male blood donors confirmed positive for syphilis (3 out of 46 screened, 6.5%). Two were estimated to have taken PrEP/PEP within a day of donating, and the third within 2 days. Two were new donors, whereas one had donated previously but acquired syphilis infection after his last donation.ConclusionsOur findings indicate that a small proportion of blood donors have not been disclosing PrEP/PEP use and therefore donating in non-compliance to donor eligibility criteria.

Absence of detectable monkeypox virus DNA in 11,000 English blood donations during the 2022 outbreak

“…These are all elements that would lead to donor deferral by NHSBT irrespective of pre‐donation reporting of mpox contacts or symptoms. Nevertheless, a small number of donors may continue to donate despite pre‐donation questions on risk that should lead to deferral 19 ; nondisclosure of infection risk is similarly apparent from studies that document high frequencies of PrEP use in U.S. and UK donors 20,21 …”

Undeclared pre-exposure or post-exposure prophylaxis (PrEP/PEP) use among syphilis-positive blood donors, England, 2020 to 2021

“…Our data show that the proportion of PrEP use among syphilis-infected male donors has not changed since the implementation of the individualised risk assessment, but the increase in the number of donors with past syphilis infection might reflect a change in donor selection policy. However, our study provides continuing evidence of blood donor non-compliance seeing as 6% of syphilis-positive male donors in 2020 and 2021 used PrEP (10/177) [4]. This time, PrEP testing was performed anonymously and hence we could not provide these results back to the donors.…”

“…It is also considered as a marker of recent likely high-risk sexual activity and can potentially hinder the detection of early HIV infection if not taken as prescribed [3]. Although individuals taking PrEP are deferred from blood donations for 3 months after completion of the course, we have previously found evidence of PrEP use in male blood donors with syphilis infection [4]. To evaluate the impact of this new donor selection policy on blood donation safety, we assessed the extent of PrEP use among syphilis-infected male donors before and after the change.…”

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

“…In addition, 4.8% of HIV-negative MSM donors reported use of prophylaxis close to the time of blood donation [ 50 ]. In syphilis-positive donors, 6.5% had detectable levels of tenofovir and/or emtricitabine, but this was not detected in samples from donors who were initially positive for HIV antibodies on screening but who were confirmed as HIV-negative [ 54 ].…”