Transfusion‐acquired cytomegalovirus infection in children in a hyperendemic area

Abstract

Thirty-nine children without previous cytomegalovirus (CMV) infection received blood transfusion in the National Taiwan University Hospital. The overall transfusion-acquired CMV infection rate was 36% (14/39). Donor CMV seropositive rate was 70%. None of the nine children who had received seronegative blood became infected, in contrast to 14 of the 21 children (67%) who had received seropositive blood (P = 0.002). Another significant risk factor associated with CMV infection was the use of fresh blood: 13 of 15 (87%) with fresh seropositive blood were infected, in contrast to one of six (17%) with "old" seropositive blood (P = 0.01). Most of the fresh blood was used within 24 hours. This blood processing method was shown to account for the extremely high rate of CMV infection in those who had received fresh seropositive blood. The results indicated that the incidence of CMV infection can be reduced by avoiding the use of fresh blood, especially blood less than 24 hours old. For such a population in Taiwan with high prevalence of positive CMV antibody, this approach was more applicable than screening donor blood for CMV antibody.

Human Herpesvirus Infections

“…[138][139][140] In nonimmunosuppressed seronegative transfusion recipients, 6 of 7 patients who seroconverted were transfused with fresh whole blood. 161 In the same study, none of the children receiving only CMV-seronegative blood developed CMV, compared to the 36% rate of CMV in children receiving unscreened blood. 155 Similar findings were made in a pediatric study where transfusiontransmitted CMV occurred in 13 of 15 children (87%) who received fresh blood (<24 hours old) as compared to 1 of 6 children (17%; p = 0.01) receiving blood more than 24 hours old.…”

“…In contrast, among 585 patients who did not seroconvert, only 53 had received fresh blood (p < 0.001). 161 Overall, the infection rate with transfusion of fresh blood has been documented at 10% to 59% (reviewed in Lee and coworkers 161 ). 161 In the same study, none of the children receiving only CMV-seronegative blood developed CMV, compared to the 36% rate of CMV in children receiving unscreened blood.…”

“…97,155,158,160,161,196 An early study of newborn infants demonstrated that none of 90 seronegative infants transfused with seronegative components contracted CMV infections, as compared to 13.5% of seronegative infants receiving transfusions from seropositive donors. 97,155,158,160,161,196 An early study of newborn infants demonstrated that none of 90 seronegative infants transfused with seronegative components contracted CMV infections, as compared to 13.5% of seronegative infants receiving transfusions from seropositive donors.…”

CMV and blood transfusions

“…In a study of nonimmunosuppressed patients, 6 of 7 who seroconverted received fresh whole blood, compared with 53 of 585 who did not seroconvert ( p<0.001) [21]. Overall, the rate of TT-CMV following transfusion of fresh blood has been estimated at 10%-59% (reviewed in [50]). While the epidemiologic evidence is convincing, experimental evidence for a decline in infectivity with storage is controversial.…”

“…Seronegative units also effectively reduced the incidence of TT-CMV in immunocompromised adult seronegative recipients of allogeneic seronegative bone marrow [17]. Although the exclusive use of CMVseronegative components remains the goldstandard for transfusion of at-risk patients [14,15,17,21,50,54], there is still a low incidence of breakthrough TT-CMV following seronegative transfusions. False-negative donor serology may Figure 1.…”