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Transfus Apher Sci. 2017 Jun;56(3):389-391. doi: 10.1016/j.transci.2017.03.010. Epub 2017 Mar 18.

Residual risk of HIV, HCV and HBV in Canada.

Author information

1
Canadian Blood Services, Canada; Dept. of Epidemiology & Community Medicine, University of Ottawa, Canada. Electronic address: sheila.obrien@blood.ca.
2
Canadian Blood Services, Canada; Dept. of Epidemiology & Community Medicine, University of Ottawa, Canada.
3
Canadian Blood Services, Canada.
4
Canadian Blood Services, Canada; Dept. of Pathology & Laboratory Medicine, University of Ottawa, Canada.
5
Canadian Blood Services, Canada; Dept. of Medical Microbiology, University of Toronto, Canada.

Abstract

BACKGROUND:

Residual risk is estimated as the product of the incidence and the infectious window period, the time during which a blood donation could be infectious but the assay may not detect it. In 2011 nucleic acid multiplex testing (MPX) was implemented in 6 unit minipools (previously 24 unit minipools). MPX also included hepatitis B (HBV) NAT for the first time (complementing HBsAg screening) in addition to HIV-1 and hepatitis C (HCV) as before. We aimed to estimate window period risk-day equivalents for MPX, and the residual risk of viral infections in blood donations updated to reflect current incidence and testing.

METHODS:

Transmissible disease conversions of repeat donations to Canadian Blood Services within the three-year period 2012-2014 divided by person-years estimated incidence for HIV, HCV and HBV (adjusted for transient viremia). Window period risk-day equivalents for MPX were estimated using a published method. Residual risk was the product of incidence and window period risk-day equivalents. 95% confidence intervals were estimated using Monte Carlo simulation of the window period risk-day equivalents and the incidence density 95% confidence intervals.

RESULTS:

The incidence rate per 100,000 person years for HIV was 0.28, HCV 1.0 and HBV 0.26. The residual risk of HIV was 1 per 21.4 million donations, HCV 1 per 12.6 million donations and HBV 1 per 7.5 million donations.

CONCLUSION:

The residual risk of infection is very low, similar to 2006-2009. The safety benefit of further shortening of the infectious window period is below the threshold to quantify.

KEYWORDS:

Incidence; Multiplex NAT; Residual risk

PMID:
28389206
DOI:
10.1016/j.transci.2017.03.010
[Indexed for MEDLINE]

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