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Clin Infect Dis. 2019 Mar 5;68(6):1001-1008. doi: 10.1093/cid/ciy596.

Infection Pressure in Men Who Have Sex With Men and Their Suitability to Donate Blood.

Author information

1
Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, Amsterdam, The Netherlands.
2
Department of Blood-borne Infections, Sanquin Research, Amsterdam, The Netherlands.
3
Department of Internal Medicine, Amsterdam Infection and Immunity Institute, Academic Medical Center, Amsterdam, The Netherlands.
4
Department of Donor Studies, Sanquin Research, Amsterdam, The Netherlands.

Abstract

BACKGROUND:

Deferral of men who have sex with men (MSM) from blood donation is highly debated. We therefore investigated their suitability to donate blood.

METHODS:

We compared the antibody prevalence of 10 sexually and transfusion-transmissible infections (TTIs) among 583 MSM and 583 age-matched repeat male blood donors. MSM were classified as low risk (lr) or medium-to-high risk (hr) based on self-reported sexual behavior and as qualified or unqualified using Dutch donor deferral criteria. Infection pressure (IP) was defined as the number of antibody-reactive infections, with class A infections (human immunodeficiency virus-1/2, hepatitis B virus, hepatitis C virus, human T-cell lymphotropic virus-1/2, syphilis) given double weight compared to class B infections (cytomegalovirus, herpes simplex virus-1/2, human herpesvirus 8, hepatitis E virus, parvovirus B19).

RESULTS:

Donors had a lower median IP than qualified lr-MSM and qualified hr-MSM (2 [interquartile range {IQR}, 1-2] vs 3 [IQR, 2-4]; P < .001). Low IP was found in 76% of donors, 39% of qualified lr-MSM, and 27% of qualified hr-MSM. The prevalence of class A infections did not differ between donors and qualified lr-MSM but was significantly higher in qualified hr-MSM and unqualified MSM. Recently acquired class A infections were detected in hr-MSM only. Compared to blood donors, human herpesviruses were more prevalent in all MSM groups (P < .001).

CONCLUSIONS:

IP correlates with self-reported risk behavior among MSM. Although lr-MSM might form a low threat for blood safety with regard to class A infections, the high seroprevalence of human herpesviruses in lr-MSM warrants further investigation.

KEYWORDS:

blood donation; deferral policy; infection pressure; men who have sex with men

PMID:
30052873
DOI:
10.1093/cid/ciy596

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