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Michael P. Busch - One of the best experts on this subject based on the ideXlab platform.
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the national heart lung and Blood institute retrovirus epidemiology Donor studies retrovirus epidemiology Donor study and retrovirus epidemiology Donor study ii twenty years of research to advance Blood product safety and availability
Transfusion Medicine Reviews, 2012Co-Authors: Steven Kleinman, Michael P. Busch, Edward L Murphy, Melissa King, S A GlynnAbstract:The Retrovirus Epidemiology Donor Study (REDS), conducted from 1989 to 2001, and the REDS-II, conducted from 2004 to 2012, were National Heart, Lung, and Blood Institute–funded, multicenter programs focused on improving Blood safety and availability in the United States. The REDS-II also included international study sites in Brazil and China. The 3 major research domains of REDS/REDS-II have been infectious disease risk evaluation, Blood donation availability, and Blood Donor characterization. Both programs have made significant contributions to transfusion medicine research methodology by the use of mathematical modeling, large-scale Donor surveys, innovative methods of repository sample storage, and establishing an infrastructure that responded to potential emerging Blood safety threats such as xenotropic murine leukemia virus–related virus. Blood safety studies have included protocols evaluating epidemiologic and/or laboratory aspects of human immunodeficiency virus, human T-lymphotropic virus 1/2, hepatitis C virus, hepatitis B virus, West Nile virus, cytomegalovirus, human herpesvirus 8, parvovirus B19, malaria, Creutzfeldt-Jakob disease, influenza, and Trypanosoma cruzi infections. Other analyses have characterized Blood Donor demographics, motivations to donate, factors influencing Donor return, behavioral risk factors, Donors' perception of the Blood donation screening process, and aspects of Donor deferral. In REDS-II, 2 large-scale Blood Donor protocols examined iron deficiency in Donors and the prevalence of leukocyte antibodies. This review describes the major study results from over 150 peer-reviewed articles published by these 2 REDS programs. In 2011, a new 7-year program, the Recipient Epidemiology and Donor Evaluation Study-III, was launched. The Recipient Epidemiology and Donor Evaluation Study-III expands beyond Donor-based research to include studies of Blood transfusion recipients in the hospital setting and adds a third country, South Africa, to the international program.
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the frequency and specificity of human neutrophil antigen antibodies in a Blood Donor population
Transfusion, 2011Co-Authors: Jerome L Gottschall, Michael P. Busch, David J Wright, Darrell J Triulzi, Brian R Curtis, Ram Kakaiya, Philip J Norris, Simone A Glynn, Danielle M Carrick, Steve KleinmanAbstract:BACKGROUND: Transfusion-related acute lung injury (TRALI) has been associated with both human leukocyte antigen (HLA) and human neutrophil antigen (HNA) antibodies. HNA antibody frequency, specificity, and demographic associations have not been well defined in the Blood Donor population. STUDY DESIGN AND METHODS: A subset of 1171 Donors (388 nontransfused males, 390 HLA antibody–negative females with three or more pregnancies, and 393 HLA antibody–positive females with three or more pregnancies) from a larger Leukocyte Antibody Prevalence Study was tested for immunoglobulin (Ig)G and IgM HNA antibody using a granulocyte immunofluorescence flow cytometry assay. Additional testing on selected samples included monoclonal antibody immobilization of granulocyte antigen–flow cytometry and granulocyte genotyping. RESULTS: Eight samples were HNA antibody positive (prevalence, 0.7%; 95% confidence interval [CI], 0.3%-1.3%]). Three HNA antibodies (one IgG and two IgM) were found in nontransfused males (prevalence, 0.8%; 95% CI, 0.2%-2.2%); all were panreactive or nonspecific. One HLA antibody–negative previously pregnant female had an IgG HNA antibody with HNA-1a specificity (prevalence, 0.3%; 95% CI, 0.01%-1.4%). Four HLA antibody–positive previously pregnant females demonstrated HNA antibodies, three IgG and one IgM (prevalence, 1%; 95% CI, 0.3%-2.6%). Two of these were HNA-1a specific, one HNA-4a specific, and one nonspecific. CONCLUSIONS: HNA antibodies occur with low frequency in the Donor population and are present in both male and female Donors. Despite the implementation of TRALI reduction strategies, HNA antibodies are still present in Donor Blood products. Although our data do not create a case for urgent implementation of Donor HNA antibody testing, future new developments for high-throughput HNA antibody screening, including for HNA-3a, may warrant reconsideration.
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genetic research in the Blood bank acceptability to northern california Donors
Transfusion, 2010Co-Authors: Megan S Rice, Michael P. Busch, Brian Custer, Nora V Hirschler, Daniel Hindes, Kimanh Nguyen, Edward L MurphyAbstract:Blood banks may be uniquely positioned to conduct large genetic epidemiologic studies. They have a broad Donor base, collect Blood samples frequently, test them for infectious agents using nucleic acid technology, and routinely collect demographic (phenotype) information into large databases.1 Large repositories of banked specimens from Blood Donors exist.2 At the same time, Blood Donor return rates are of increasing concern to Blood banks and the potential adverse impact of genetic studies on these rates are unknown.3,4 Researchers have examined participation rates in genetic studies in other US populations and have found that the acceptability of allowing future unlimited research on stored specimens varies widely. In a recent review, Sterling and coworkers5 found that consent rates for genetic studies among individuals who had previously participated in health research ranged from 21% to 85%. Consent rates varied by demographic characteristics such as sex and race and/or ethnicity. The REDS-II study recently reported that 91% of Donors who consented for a study of HLA antibodies were also willing to have their Blood samples stored in a biorepository for future research use to “improve our understanding of transfusion biology and transfusion safety.”6 Odds of repository participation were lower for subjects who were African American or Hispanic, were 35 to 44 years old, or had not completed high school and were lowest at one geographic location, regardless of other variables. But to our knowledge, there have been no studies specifically examining US Blood Donor opinions on participation in genetic research or testing and intention of ongoing donation if such research were undertaken by the Blood center. We therefore conducted a survey among Blood Donors with three goals: to assess Blood Donor interest in participating in genetic studies through Blood banks, to measure the potential impact of genetic studies on future Blood donations, and to estimate Donor interest in genetic testing offered by Blood banks as an optional service.
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experience of german red cross Blood Donor services with nucleic acid testing results of screening more than 30 million Blood donations for human immunodeficiency virus 1 hepatitis c virus and hepatitis b virus
Transfusion, 2008Co-Authors: M K Hourfar, Michael P. Busch, Christine Jork, Volkmar Schottstedt, Marijke Weberschehl, Veronika Brixner, Geert Geusendam, Knut Gubbe, Christina Mahnhardt, Uschi MayrwohlfartAbstract:BACKGROUND: The risk of transfusion-transmitted human immunodeficiency virus-1 (HIV-1), hepatitis C virus (HCV), and hepatitis B virus (HBV) infections is predominantly attributable to donations given during the early stage of infection when diagnostic tests may fail. In 1997, nucleic acid amplification technique (NAT)-testing was introduced at the German Red Cross (GRC) Blood Donor services to reduce this diagnostic window period (WP). STUDY DESIGN AND METHODS: A total of 31,524,571 Blood donations collected from 1997 through 2005 were screened by minipool NAT, predominantly with pool sizes of 96 donations. These donations cover approximately 80 percent of all the Blood collected in Germany during that period. Based on these data, the WP risk in the GRC Blood Donor population was estimated by using a state-of-the-art mathematic model. RESULTS: During the observation period, 23 HCV, 7 HIV-1, and 43 HBV NAT-only–positive donations were detected. On the basis of these data and estimated pre-NAT infectious WPs, the residual risk per unit transfused was estimated at 1 in 10.88 million for HCV (95% confidence interval [CI], 7.51-19.72 million), 1 in 4.30 million for HIV-1 (95% CI, 2.39-21.37 million), and 1 in 360,000 for HBV (95% CI, 0.19-3.36 million). Based on observed cases of breakthrough infections, the risk of transfusion-related infections may be even lower. CONCLUSION: The risk of a Blood recipient becoming infected with HCV, HIV-1, or HBV has reached an extremely low level. Introduction of individual donation testing for HCV and HIV-1 would have a marginal effect on interception of WP donations.
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west nile virus infections projected from Blood Donor screening data united states 2003
Emerging Infectious Diseases, 2006Co-Authors: Michael P. Busch, Leslie H Tobler, Celso Bianco, Gregory A Foster, Susan L Stramer, David J Wright, Brian Custer, Steven Kleinman, Harry E Prince, Lyle R PetersenAbstract:National Blood Donor screening for West Nile virus (WNV) RNA using minipool nucleic acid amplification testing (MP-NAT) was implemented in the United States in July 2003. We compiled national NAT yield data and performed WNV immunoglobulin M (IgM) testing in 1 WNV-epidemic region (North Dakota). State-specific MP-NAT yield, antibody seroprevalence, and the average time RNA is detectable by MP-NAT were used to estimate incident infections in 2003. WNV Donor screening yielded 944 confirmed viremic Donors. MP-NAT yield peaked in August with >0.5% of donations positive for WNV RNA in 4 states. Peak IgM seroprevalence for North Dakota was 5.2% in late September. The average time viremia is detectable by MP-NAT was 6.9 days (95% confidence interval [CI] 3.0-10.7). An estimated 735,000 (95% CI 322,000-1,147,000) infections occurred in 2003, with 256 (95% CI 112-401) infections per neuroinvasive case. In addition to preventing transfusion-transmitted WNV infection, Donor screening can serve as a tool to monitor seasonal incidence in the general population.
Uschi Mayrwohlfart - One of the best experts on this subject based on the ideXlab platform.
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human immunodeficiency virus 1 dual target nucleic acid technology improves Blood safety 5 years of experience of the german red cross Blood Donor service baden wurttemberg hessen
Transfusion, 2018Co-Authors: Kai Hourfar, Julia Kress, Michael Chudy, Uschi Mayrwohlfart, Josef Eberle, Markus Muller, Micha C Nubling, Lutz Gurtler, Hubert Schrezenmeier, Inke HellmannAbstract:BACKGROUND: RNA viruses are associated with a high frequency of mutations because of the missing proofreading function of polymerases, such as reverse transcriptase. Between 2007 and 2010, six Blood donations with false-negative nucleic acid technology (NAT) results were reported in Germany. Therefore, NAT screening in two viral genome regions was introduced by our Blood donation service in 2010 on a voluntary basis and became mandatory in Germany since the beginning of 2015. STUDY DESIGN AND METHODS: Blood Donor screening was done using, in parallel, the German Red Cross (GRC) HIV-1 CE long terminate repeats (LTR) PCR kit and the GRC HIV-1 gag CE PCR kit. In total, 7 million Blood donations were screened during the study period from 2010 to 2014 with the GRC dual-target human immunodeficiency virus 1 (HIV-1) NAT system. Additionally, three suspicious specimens were analyzed by four monotargeted NAT assays and by five dual target NAT assays. RESULTS: Three of 7 million donations tested negative using the 5'LTR polymerase chain reaction, but they were positive if amplification was performed in the gag region. HIV antibodies were detected in all three donations. Nucleic acid sequence analysis identified a deletion of 22 bases within the 5'LTR probe binding region. Three different /tr-based monotargeted assays missed two donations, except for a low-reactive result obtained by one of the assays. In total, the detection rates for HIV-1 positive donations were 37.5% (3/8) for monotargeted assays and 100% (10/10) for dual-target assays. CONCLUSION: The current data demonstrate that dual-target NAT systems reduce the risk of false negative HIV-1 NAT screening results.
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experience of german red cross Blood Donor services with nucleic acid testing results of screening more than 30 million Blood donations for human immunodeficiency virus 1 hepatitis c virus and hepatitis b virus
Transfusion, 2008Co-Authors: M K Hourfar, Michael P. Busch, Christine Jork, Volkmar Schottstedt, Marijke Weberschehl, Veronika Brixner, Geert Geusendam, Knut Gubbe, Christina Mahnhardt, Uschi MayrwohlfartAbstract:BACKGROUND: The risk of transfusion-transmitted human immunodeficiency virus-1 (HIV-1), hepatitis C virus (HCV), and hepatitis B virus (HBV) infections is predominantly attributable to donations given during the early stage of infection when diagnostic tests may fail. In 1997, nucleic acid amplification technique (NAT)-testing was introduced at the German Red Cross (GRC) Blood Donor services to reduce this diagnostic window period (WP). STUDY DESIGN AND METHODS: A total of 31,524,571 Blood donations collected from 1997 through 2005 were screened by minipool NAT, predominantly with pool sizes of 96 donations. These donations cover approximately 80 percent of all the Blood collected in Germany during that period. Based on these data, the WP risk in the GRC Blood Donor population was estimated by using a state-of-the-art mathematic model. RESULTS: During the observation period, 23 HCV, 7 HIV-1, and 43 HBV NAT-only–positive donations were detected. On the basis of these data and estimated pre-NAT infectious WPs, the residual risk per unit transfused was estimated at 1 in 10.88 million for HCV (95% confidence interval [CI], 7.51-19.72 million), 1 in 4.30 million for HIV-1 (95% CI, 2.39-21.37 million), and 1 in 360,000 for HBV (95% CI, 0.19-3.36 million). Based on observed cases of breakthrough infections, the risk of transfusion-related infections may be even lower. CONCLUSION: The risk of a Blood recipient becoming infected with HCV, HIV-1, or HBV has reached an extremely low level. Introduction of individual donation testing for HCV and HIV-1 would have a marginal effect on interception of WP donations.
Susan L Stramer - One of the best experts on this subject based on the ideXlab platform.
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chagas disease serological test performance in u s Blood Donor specimens
Journal of Clinical Microbiology, 2019Co-Authors: Jeffrey D Whitman, Susan L Stramer, Christina A Bulman, Emma L Gunderson, Amanda M Irish, Rebecca L Townsend, Judy A Sakanari, Caryn BernAbstract:ABSTRACT Chagas disease affects an estimated 300,000 individuals in the United States. Diagnosis in the chronic phase requires positive results from two different IgG serological tests. Three enzyme-linked immunosorbent assays (ELISAs) (Hemagen, Ortho, and Wiener) and one rapid test (InBios) are FDA cleared, but comparative data in U.S. populations are sparse. We evaluated 500 seropositive and 300 seronegative Blood Donor plasma samples. Country of birth was known for 255 seropositive specimens, which were grouped into regions as follows: Mexico (n = 94), Central America (n = 88), and South America (n = 73). Specimens were tested by the four FDA-cleared IgG serological assays. Test performance was evaluated by two comparators and latent class analysis. InBios had the highest sensitivity (97.4% to 99.3%) but the lowest specificity (87.5% to 92.3%). Hemagen had the lowest sensitivity (88.0% to 92.0%) but high specificity (99.0% to 100.0%). The level of sensitivity was intermediate for Ortho (92.4% to 96.5%) and Wiener (94.0% to 97.1%); both had high specificity (98.8% to 100.0% and 96.7% to 99.3%, respectively). The levels of antibody reactivity and clinical sensitivity were lowest in Donors from Mexico, intermediate in those from Central America, and highest in those from South America. Our findings provide an initial evidence base to improve laboratory diagnosis of Chagas disease in the United States. The best current testing algorithm would employ a high-sensitivity screening test followed by a high-specificity confirmatory test.
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chagas disease serological test performance in united states Blood Donor specimens
bioRxiv, 2019Co-Authors: Jeffrey D Whitman, Susan L Stramer, Christina A Bulman, Emma L Gunderson, Amanda M Irish, Rebecca L Townsend, Judy A Sakanari, Caryn BernAbstract:ABSTRACT Background Chagas disease affects an estimated 300,000 individuals in the US. Diagnosis in the chronic phase requires positive results by two different IgG serological tests. Three ELISAs (Hemagen, Ortho, Wiener) and one rapid test (InBios) are FDA-cleared, but comparative data in US populations are sparse. Methods We evaluated 500 seropositive and 300 seronegative Blood Donor plasma samples. Country of birth was known for 255 seropositive specimens and grouped into regions: Mexico (n=94), Central America (n=88) and South America (n=73). Specimens were tested by the four FDA-cleared IgG serological assays. Test performance was evaluated by two comparators and latent class analysis. Results InBios had the highest sensitivity (97.4-99.3%), but lowest specificity (87.5-92.3%). Hemagen had the lowest sensitivity (88.0-92.0%), but high specificity (99.0-100.0%). Sensitivity was intermediate for Ortho (92.4-96.5%) and Wiener (94.0-97.1%); both had high specificity (98.8-100.0% and 96.7-99.3%, respectively). Antibody reactivity and clinical sensitivity was lowest in Donors from Mexico, intermediate in those from Central America and highest in those from South America. Conclusions Our findings provide an initial evidence base to improve laboratory diagnosis of Chagas disease in the US. The best current testing algorithm would employ a high sensitivity screening test followed by a high specificity confirmatory test.
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Blood Donor testing for hepatitis b virus in the united states is there a case for continuation of hepatitis b surface antigen detection
Transfusion, 2018Co-Authors: Roger Y Dodd, David E Krysztof, Megan L Nguyen, Edward P Notari, Susan L StramerAbstract:BACKGROUND: In the United States, Blood Donor testing for hepatitis B surface antigen (HBsAg) was initiated in the early 1970s. More recently, testing for antibody to hepatitis B core antigen (anti-HBc) and hepatitis B virus (HBV) DNA have been added. The incidence of hepatitis B has been declining. This study reviews the current status of testing and questions the need for continuation of HBsAg testing. STUDY DESIGN AND METHODS: From July 2011 to June 2015, a total of 22.4 million donations were serologically tested for HBsAg and anti-HBc and for HBV-DNA by nucleic acid testing (NAT). All reactive results were evaluated and a subset of donations that were either potential NAT yield (seronegative) or serologically positive but nonreactive by HBV NAT in minipools (MPs) of 16 were further evaluated by individual donation (ID)-NAT. Samples with detectable HBV DNA were defined as actively infected and considered potentially infectious. RESULTS: Routine testing plus supplemental ID-NAT identified 2035 samples representing active infection including 1965 with anti-HBc, 1602 with HBsAg, and 1453 with HBV DNA by MP-NAT, for respective rates per hundred-thousand donations of 9.10, 8.78, 7.16, and 6.50, continuing the downward trend previously observed. There were 29 HBV DNA-yield samples (1:771,389), 35 HBsAg-yield samples (anti-HBc nonreactive), and 404 with occult hepatitis B infection. There were six samples with HBsAg and HBV DNA detectable only by ID-NAT in the absence of anti-HBc; additional testing was consistent with extremely low or negligible levels of DNA. CONCLUSIONS: Point estimates of HBV infection rates among Blood Donors continue to decline, as do those for incidence and residual risk. Elimination of HBsAg screening would have negligible impact, with a risk less than 1 per 4 million donations.
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west nile fever characteristics among viremic persons identified through Blood Donor screening
The Journal of Infectious Diseases, 2010Co-Authors: Shimian Zou, Gregory A Foster, Roger Y Dodd, Lyle R Petersen, Susan L StramerAbstract:Nucleic acid testing (NAT) of Blood Donors provides opportunities for identifying West Nile virus (WNV)-infected persons before symptoms develop and for characterizing subsequent illness. From June 2003 through 2008, the American Red Cross performed follow‐up interviews with and additional laboratory testing for 1436 Donors whose donations had initial test results that were reactive for WNV RNA; 821 of the Donors were subsequently confirmed to have WNV infection, and the remainder were unconfirmed or determined to have false‐positive results. Symptoms attributed to WNV infection were determined by comparing symptom frequency among 576 Donors identified with early WNV infection (immunoglobulin M antibody negative) and those with unconfirmed infection. We estimate that 26% of WNV‐infected persons become symptomatic, defined by the presence of at least 3 of 8 indicator symptoms. Nearly one‐half of symptomatic persons sought medical care; only 5% received a diagnosis of WNV infection. Female subjects and persons with higher viral loads detected in the index donation were more likely than other subjects to develop symptoms.
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west nile virus infections projected from Blood Donor screening data united states 2003
Emerging Infectious Diseases, 2006Co-Authors: Michael P. Busch, Leslie H Tobler, Celso Bianco, Gregory A Foster, Susan L Stramer, David J Wright, Brian Custer, Steven Kleinman, Harry E Prince, Lyle R PetersenAbstract:National Blood Donor screening for West Nile virus (WNV) RNA using minipool nucleic acid amplification testing (MP-NAT) was implemented in the United States in July 2003. We compiled national NAT yield data and performed WNV immunoglobulin M (IgM) testing in 1 WNV-epidemic region (North Dakota). State-specific MP-NAT yield, antibody seroprevalence, and the average time RNA is detectable by MP-NAT were used to estimate incident infections in 2003. WNV Donor screening yielded 944 confirmed viremic Donors. MP-NAT yield peaked in August with >0.5% of donations positive for WNV RNA in 4 states. Peak IgM seroprevalence for North Dakota was 5.2% in late September. The average time viremia is detectable by MP-NAT was 6.9 days (95% confidence interval [CI] 3.0-10.7). An estimated 735,000 (95% CI 322,000-1,147,000) infections occurred in 2003, with 256 (95% CI 112-401) infections per neuroinvasive case. In addition to preventing transfusion-transmitted WNV infection, Donor screening can serve as a tool to monitor seasonal incidence in the general population.
Jeanpierre Allain - One of the best experts on this subject based on the ideXlab platform.
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prevalence of hepatitis b surface antigen hbsag in a Blood Donor population born prior to and after implementation of universal hbv vaccination in shenzhen china
BMC Infectious Diseases, 2016Co-Authors: Zhen Wang, Jinfeng Zeng, Tingting Li, Xin Zheng, Xiaoxuan Xu, Xianlin Ye, Liang Lu, Baocheng Yang, Jeanpierre AllainAbstract:Neonatal hepatitis B vaccination program at birth has been implemented nationwide since 1992 in China. However, current HBV prevalence status in Blood Donors has not been entirely examined, which may impact HBV safety in Blood donations as the vaccinees over 18 years old progressively become the majority population of Blood Donors. In this study, 569,145 Blood Donors were screened for HBsAg by rapid tests and enzyme immunoassays, among them 475,538 Blood samples with negative HBsAg were further screened for HBV DNA by nucleic acid testing between 2005 and 2014 at Shenzhen Blood center. An overall 2.3 % HBsAg prevalence was found in the Blood Donor population during the past 10 years (2.86 % in 2005, 1.76 % in 2010, and 2.79 % in 2014, respectively). HBsAg seroconversion occurred in 0.37 % of repeat-Donors. When stratified by age, the prevalence of HBsAg was found significantly higher in younger Donors age 18–25 years (2.73 %) than in those 26–35 years (2.13 %), 36–45 years (2.03 %) and 46–58 years (1.71 %) (P < 0.001), unexpectedly suggesting that younger Donors remained at risk of chronic HBV infection. Assuming that Donors aged 18–22 born before or after 1992 were non-vaccinated and vaccinated, respectively, HBsAg prevalence was higher in first-time Donors born ≥1992 (3.9 %) than prior to 1992 (3.5 %, P = 0.005). The incidence of HBV infection in the 5-year period examined was significantly lower in repeat-Donors born ≥1992 (0.27 %) than prior to 1992 (0.6 %, P = 0.008). The yield of HBV DNA+/HBsAg- Donors was 1:3,302, including 1:4,486 occult infections and 1:43,231 window period infections. Young Blood Donors born after implementation of universal HBV vaccination in China presented higher prevalence of HBsAg but lower incidence of HBsAg seroconversion than older, presumed unvaccinated, Donors. HBV vaccine boosting for adolescents at 15–17 years old prior to reaching Blood Donor age might help improve Blood safety.
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moving on from voluntary non remunerated Donors who is the best Blood Donor
British Journal of Haematology, 2011Co-Authors: Jeanpierre AllainAbstract:Blood transfusion safety in sub-Saharan Africa (SSA) is marred by the high prevalence of infectious agents, chronic Blood shortage and lack of resources. However, considerable pressure is applied by richer countries and international transfusion bodies to establish voluntary, non-remunerated Blood Donors (VNRD) as the only source of Blood, excluding the traditional family/replacement Donors on the grounds of a higher level of safety. Such a policy increases the cost of a unit of Blood by two to fivefold and exacerbates the pre-existing Blood shortage. This review provides compelling evidence that first-time VNRD are no safer than family/replacement Donors and that only repeat donation provides improved Blood safety. In order to limit Blood shortage and maintain affordability of the Blood supply in SSA, both types of Donors should be accepted and both should be encouraged to donate regularly.
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identification and characterization of persistent human erythrovirus infection in Blood Donor samples
Journal of Virology, 2004Co-Authors: Daniel Candotti, Nermin Etiz, Armen Parsyan, Jeanpierre AllainAbstract:The presence of human erythrovirus DNA in 2,440 Blood donations from the United Kingdom and sub-Saharan Africa (Ghana, Malawi, and South Africa) was screened. Sensitive qualitative and real-time quantitative PCR assays revealed a higher prevalence of persistent infection with the simultaneous presence of immunoglobulin G (IgG) and viral DNA (0.55 to 1.3%) than previously reported. This condition was characterized by a low viral load (median, 558 IU/ml; range, 42 to 135,000 IU/ml), antibody-complexed virus, free specific IgG, and potentially infectious free virus. Human erythrovirus genotype 1 (formerly parvovirus B19) was prevalent in the United Kingdom, Malawi, and South Africa. In contrast, only human erythrovirus genotype 3 (erythrovirus variant V9) was prevalent in Ghana. Genotype 3 had considerable genetic diversity, clustering in two probable subtypes. Genotype 1-based antibody assays failed to detect 38.5% of Ghanaian samples containing antibodies to genotype 3 virus but did not fail to detect cases of persistent infection. This study indicates a potential African origin of genotype 3 human erythrovirus and considerable shortcomings in the tools currently used to diagnose erythrovirus infection.
Inke Hellmann - One of the best experts on this subject based on the ideXlab platform.
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human immunodeficiency virus 1 dual target nucleic acid technology improves Blood safety 5 years of experience of the german red cross Blood Donor service baden wurttemberg hessen
Transfusion, 2018Co-Authors: Kai Hourfar, Julia Kress, Michael Chudy, Uschi Mayrwohlfart, Josef Eberle, Markus Muller, Micha C Nubling, Lutz Gurtler, Hubert Schrezenmeier, Inke HellmannAbstract:BACKGROUND: RNA viruses are associated with a high frequency of mutations because of the missing proofreading function of polymerases, such as reverse transcriptase. Between 2007 and 2010, six Blood donations with false-negative nucleic acid technology (NAT) results were reported in Germany. Therefore, NAT screening in two viral genome regions was introduced by our Blood donation service in 2010 on a voluntary basis and became mandatory in Germany since the beginning of 2015. STUDY DESIGN AND METHODS: Blood Donor screening was done using, in parallel, the German Red Cross (GRC) HIV-1 CE long terminate repeats (LTR) PCR kit and the GRC HIV-1 gag CE PCR kit. In total, 7 million Blood donations were screened during the study period from 2010 to 2014 with the GRC dual-target human immunodeficiency virus 1 (HIV-1) NAT system. Additionally, three suspicious specimens were analyzed by four monotargeted NAT assays and by five dual target NAT assays. RESULTS: Three of 7 million donations tested negative using the 5'LTR polymerase chain reaction, but they were positive if amplification was performed in the gag region. HIV antibodies were detected in all three donations. Nucleic acid sequence analysis identified a deletion of 22 bases within the 5'LTR probe binding region. Three different /tr-based monotargeted assays missed two donations, except for a low-reactive result obtained by one of the assays. In total, the detection rates for HIV-1 positive donations were 37.5% (3/8) for monotargeted assays and 100% (10/10) for dual-target assays. CONCLUSION: The current data demonstrate that dual-target NAT systems reduce the risk of false negative HIV-1 NAT screening results.