Residual risk of transmission of human immunodeficiency virus and hepatitis C virus infections by blood transfusion in northern Brazil

Abstract

BACKGROUND Nucleic acid test (NAT) blood screening for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) was introduced in northern Brazil in July 2012. There are several Brazilian articles that have evaluated transfusion transmission risks for HIV and HCV. However, to our knowledge, this article is the first to evaluate the impact of HIV and HCV NAT implementation for blood screening in northern Brazil. The aim of this study was to determine the prevalence and incidence rates of HIV and HCV among blood donors and to compare the residual risk of transfusion transmission of these infections, before (2009‐2011) and after (2012‐2014) NAT implementation. STUDY DESIGN AND METHODS HIV and HCV prevalence and incidence were calculated based on rates of confirmed positive samples. Residual risk estimates were based on the incidence and window model described previously. Logistic and Poisson regressions were used in the statistical analysis. A p value of not more than 0.05 was considered significant. RESULTS HIV and HCV prevalence were 209.9 and 66.3 per 100,000 donations, respectively. Residual risk for HIV and HCV decreased significantly throughout the two study periods, mainly for HCV in which the reduction was one in 169,492 to one in 769,231 donations. For HIV, the decrease was one in 107,527 to one in 769,231 donations. HIV and HCV incidence rates were 21.13 and 3.06 per 100,000 persons/year before NAT and 14.03 and 2.65 per 100,000 persons/year after NAT. CONCLUSION The HIV and HCV NAT implementation significantly increased the transfusion safety in northern Brazil, bringing benefits to recipients due to better quality of blood products produced.

10‐year analysis of human immunodeficiency virus incidence in first‐time and repeat donors in Brazil

“…Estimation of residual risk is an important tool to assess whether reductions in TT‐HIV risk are being achieved [20]. Previous research in the Northeast of Brazil for the period 2012‐2014 from the State of Pará (with approximately eight million inhabitants) support the order of magnitude of the residual risk we report [21]. Our estimates show that residual risk of HIV transfusion transmission in Brazil is higher than in many other countries, such as Germany, reported as 0·52 [22], France 0·40 [23] and Canada 0·04 [24] per million RBC transfusions.…”

Hepatitis C virus prevalence and incidence estimates among Chinese blood donors

“…In conclusion, using donation data from five Chinese regional blood centers, we provide a robust estimation of HCV prevalence in first‐time donors and HCV incidence among repeat blood donors. Our findings suggest that the HCV prevalence and incidence among blood donors in China are higher than in developing as well as developed countries (incidence of 1, 1.58, 5, 2.65, and 6.91 in 100,000 person in Canada in 2012‐2014, Italy in 2015, the United States in 1999‐2008, Brazil in 2012‐2014, and Tehran in 2005‐2010, respectively) . Continued strong efforts and surveillance are still needed to monitor and control the risk of transfusion‐transmitted HCV transfusion in China.…”

Prevalence, incidence and residual risk of transfusion-transmitted HBV infection before and after the implementation of HBV-NAT in northern Brazil

“…In the Center for Hemotherapy and Hematology of Pará (HEMOPA) Foundation–responsible for the most blood and hemocomponents transfused in the State of Pará (northern Brazil with approximately eight million inhabitants), it has been implemented in 2012 for HIV and HCV. Afterwards, in January 2015, the screening for HBV was included and now is currently used concomitant with serological test: HBV surface antigen (HBsAg) and antibodies to HBV core antigen (anti-HBc) [12].…”