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Edward L Murphy - One of the best experts on this subject based on the ideXlab platform.
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trends in serological markers of transfusion transmissible infections in Blood donations at the bamenda hospital based Blood service cameroon
Transfusion Clinique Et Biologique, 2021Co-Authors: Moses Samje, Victor N Fondoh, Georges Nguefacktsague, Laure K J Kamalieuk, Dora Mbanya, Edward L Murphy, Claude Tayou TagnyAbstract:Abstract Objectives The rate and trend of transfusion transmissible infections (TTIs) in Blood donations from 2012 to 2017 at the Bamenda Regional Hospital Blood Service (BRHBS), Cameroon was assessed. Materials and methods A six-year retrospective study was conducted by reviewing the records of donors. Blood was screened for HIV, hepatitis B, hepatitis C and syphilis. Data was analyzed using IBM SPSS Statistics version 21. Differences in seropositivity rates for the four TTIs were analyzed using Chi2 test or Fisher's exact test where appropriate. Associations between sociodemographic characteristics and the TTIs markers were assessed using multiple logistic regression analysis. Results A total of 12,115 Blood donations was included in the study and of these, the overall seropositivity rate of the four conventional TTIs markers was 10.5% (n = 1,273). Of the seropositive cases, 23.8% (n = 303) showed reactivity with at least two of the markers combined. When the markers were assessed individually, HBsAg recorded the highest seropositivity rate (4.7%), followed by anti-HIV and anti-syphilis (2.2%), and then by anti-HCV (1.7%). A significant decrease in the trend of the combined serological markers, HBsAg and anti-syphilis was observed over the years (P ≤ 0.05). Conclusion There is a decrease in seropositivity rates of TTIs markers in this Blood service. Ongoing efforts toward the prevention of these infections is encouraged and should be intensified to improve Blood Safety.
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updated characteristics of Blood services donors and Blood products in 11 french speaking african countries
Vox Sanguinis, 2018Co-Authors: Claude Tayou Tagny, Syria Laperche, Edward L MurphyAbstract:BACKGROUND AND OBJECTIVES The Francophone Africa Transfusion Research Network conducted the first large and comprehensive surveys on the status of Blood Safety in francophone African countries in 2009 and 2012. Since then, there has been substantial investment in Blood Safety but little is known about progress made in the region. MATERIALS AND METHODS This multicentre cross-sectional study describes characteristics of Blood services, donors and Blood products and compares results with previous data. A web-based questionnaire collected data of 2016 from 38 Blood facilities in 11 French-speaking countries. Data were analysed according to type of Blood services and compared to similar studies conducted in 2009 and 2012. RESULTS The study included data on 572 933 donations from 366 844 donors. Compared to 2012, there was an increase in the median proportion of voluntary nonremunerated Blood donation (+22%) (P = 0·004), and a reduction from 2·1 to 0·9 (P = 0·01), from 10·3 to 6·7 (P = 0·00), from 3·2 to 1·3 (P = 0·006) and from 1 to 0·4 (P = 0·03) in median seroprevalences of HIV, HBV, HCV and syphilis, respectively. The median proportion of Blood orders fulfilled decreased (-18·2%) (P = 0·001). The number of technical staff per 1000 donations ranged from 1 to 54 with hospital-based Blood transfusion services having 12-fold more staff than National and Regional services. CONCLUSION Several indicators have improved in Francophone Africa Blood services during the last 5 years and national and regional services likely have better indicators than hospital-based services. These findings may support the need for ongoing Blood Safety initiatives.
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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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Blood transfusion Safety in africa a literature review of infectious disease and organizational challenges
Transfusion Medicine Reviews, 2012Co-Authors: Edward L Murphy, Evan M Bloch, Marion VermeulenAbstract:Blood Safety remains an important public health concern in Africa where lack of availability or provision of unsafe Blood adversely impacts morbidity and mortality in the region. In recognition of this shortfall, the World Health Organization (WHO) established a goal of regional Blood Safety by 2012 through improved “organization and management, Blood donor recruitment and collection, testing of donor Blood as well as appropriate clinical use of Blood” (Tagny et al: Transfusion . 2008;48:1256-1261; Tapko et al: Status of Blood Safety in the WHO African Region: Report of the 2006 Survey http://www.afro.who.int/en/divisions-a-programmes/dsd/health-technologies-a-laboratories.html . Brazzaville, Republic of Congo: WHO Regional Office for Africa; 2006). Although there has been substantial progress toward meeting these objectives, there are continued obstacles to both development and sustainability. In a setting where transfusion oversight is still being improved, transfusion-transmitted infections are of real concern. The high prevalence of some transfusion-transmissible agents such as hepatitis B virus and HIV in the general population means that some infected Blood units escape detection by even well-performed laboratory testing, resulting in potential downstream transmission to patients. The spectrum of transfusion-transmitted infection include conventional as well as exotic pathogens, many of which are endemic to the region, thereby imparting ongoing challenges to recruitment and testing strategies.
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human immunodeficiency virus test seeking Blood donors in a large Blood bank in sao paulo brazil
Transfusion, 2010Co-Authors: Thelma T Goncalez, Michael P. Busch, Brian Custer, Edward L Murphy, Ester Cerdeira Sabino, Nanci Sales, Yeahung Chen, Dalton De Alencar Fischer Chamone, Willi McfarlandAbstract:Background: Persons with human immunodeficiency virus (HIV) risk behaviors are excluded from donation to reduce the risk of transfusion-transmitted infection. Persons donating to be tested for HIV may therefore deny risk behaviors. Study design and methods: A random sample of donors completed a survey on motivations knowledge and attitudes on the screening process. Donors were considered test seekers if they agreed with two statements "I think that Blood donation is a good fast and anonymous way to get my Blood tested" and "I donate to get my test results." This study was conducted from June to November 2006 at the largest Blood bank in Sao Paulo Brazil. Results: Of 3061 participants 208 (7%) were test seekers. They tended to be male and had a lower educational level. They were more likely to have incorrect knowledge about Blood Safety (e.g. not knowing that a unit can test antibody negative and still transmit infection 50% vs. 42% p = 0.02) express dissatisfaction with screening questions (e.g. feeling that important questions were not asked 14% vs. 5% p < 0.01) and concur that donors do not answer questions truthfully (e.g. donors have more sexual partners than they admit 29% vs. 18% p < 0.01). Test seekers were more likely to believe that it is acceptable to donate Blood to get tested for HIV (41% vs. 10% p < 0.01). ConclusionS: Test-seeking motivation coupled with low knowledge of window period risk is counter to improving Blood Safety and to donor prevention needs. Donor education needs to be improved along with availability of appropriate HIV counseling and testing.
Jeanpierre Allain - One of the best experts on this subject based on the ideXlab platform.
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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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hepatitis b virus hbv infection and recombination between hbv genotypes d and e in asymptomatic Blood donors from khartoum sudan
Journal of Clinical Microbiology, 2011Co-Authors: Shaza Mahgoub, Daniel Candotti, Magdy El Ekiaby, Jeanpierre AllainAbstract:Sudan is a highly endemic area for hepatitis B virus (HBV), and >5% of Blood donors are chronically infected. To examine potential strategies to improve HBV Blood Safety, 404 replacement donor samples previously screened for HBV surface antigen (HBsAg) were tested for antibody to HBV core (anti-HBc), anti-surface antigen (anti-HBs), and HBV DNA. Of 145 anti-HBc-containing samples (36%) identified, 16 retested were HBsAg positive (11%). Anti-HBs was detected in 43/77 (56%) anti-HBc-reactive samples. Six samples were HBsAg−/anti-HBc+/anti-HBs+ and contained HBV DNA, meeting the definition of occult HBV infection (OBI). OBIs had low HBV DNA loads (<10 IU/ml) and were genotype B (n = 1) or genotype D (n = 5). Pre-S/S and/or whole genome sequences were obtained from 47 randomly selected HBsAg-positive donors added to the previous 16. Genotype E was identified in 27 strains (57.5%), genotype D in 19 strains (40.5%), and genotype A2 in 1 strain (2%). Two outlier strains within genotype D ultimately were identified as recombinants of genotypes D and E with identical recombination points, suggesting circulating, infectious, recombinant strains. Anti-HBc screening does not appear to be a sustainable Blood Safety strategy because of the cost and the negative impact on the Sudanese Blood supply, even when reduced by anti-HBs testing. Being at the junction between two main African HBV genotypes, genetic recombination occurred and became part of the molecular epidemiology of HBV in Sudan.
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hepatitis b virus hbv infection and recombination between hbv genotypes d and e in asymptomatic Blood donors from khartoum sudan
Journal of Clinical Microbiology, 2011Co-Authors: Shaza Mahgoub, Daniel Candotti, Magdy El Ekiaby, Jeanpierre AllainAbstract:ABSTRACT Sudan is a highly endemic area for hepatitis B virus (HBV), and >5% of Blood donors are chronically infected. To examine potential strategies to improve HBV Blood Safety, 404 replacement donor samples previously screened for HBV surface antigen (HBsAg) were tested for antibody to HBV core (anti-HBc), anti-surface antigen (anti-HBs), and HBV DNA. Of 145 anti-HBc-containing samples (36%) identified, 16 retested were HBsAg positive (11%). Anti-HBs was detected in 43/77 (56%) anti-HBc-reactive samples. Six samples were HBsAg−/anti-HBc+/anti-HBs+ and contained HBV DNA, meeting the definition of occult HBV infection (OBI). OBIs had low HBV DNA loads (
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predonation screening of Blood donors with rapid tests implementation and efficacy of a novel approach to Blood Safety in resource poor settings
Transfusion, 2005Co-Authors: Shirley Owusuofori, Francis Sarkodie, Daniel Candotti, Jillian Temple, Margaret Anokwa, Jeanpierre AllainAbstract:BACKGROUND: In sub-Saharan Africa, the percentage of screened Blood is limited to approximately 75 percent for human immunodeficiency virus antibodies (anti-HIV), 50 percent for hepatitis B surface antigen, and 19 percent for hepatitis C virus antibodies (anti-HCV), mainly because of costs. STUDY DESIGN AND METHODS: In 2002 to 2003, candidate Blood donors were screened before donation for HIV, HCV, and hepatitis B virus (HBV) serologic markers with rapid tests. The efficacy of this screening was assessed by nucleic acid testing (NAT) applied to pools of 10 plasma samples from donated units with a virus specific triplex assay. NAT-reactive pools were resolved by viral genome identification in individual plasma sample. Deferred candidate donors were referred to a donor-care program. RESULTS: A total of 9372 people were screened and 1534 (16.4%) were deferred. No HIV or HCV RNA–containing samples remained undetected by rapid tests unless a human testing error was involved. In contrast, 1.3 and 3.0 percent of HBV DNA–containing Blood units were negative with rapid tests but were detected in individual donations with enzyme immunoassay and genomic amplification, respectively. Only half of these units were detectable in pools of 10 samples. One-third of deferred candidate donors attended the donor-care program and were informed and counseled. CONCLUSIONS: Predonation viral screening of Blood donors is effective in high endemic areas, and the savings it generates may improve the Safety and limit the cost of Blood. Communication with deferred donors may contribute to public health. A new screening strategy associating serologic rapid test before donation and NAT on pools of 10 plasma samples after donation is proposed.
Michael P. Busch - One of the best experts on this subject based on the ideXlab platform.
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Proceedings of the Food and Drug Administration public workshop on pathogen reduction technologies for Blood Safety 2018 (Commentary, p. 3026)
Transfusion, 2019Co-Authors: Chintamani D. Atreya, Steve Kleinman, Sara Rutter, David A. Reeve, Sharon A. Glynn, Edward L Snyder, James P Aubuchon, Willy A Flegel, Michael P. Busch, Dana DevineAbstract:On November 29, 2018, experts in the field of infectious diseases, pathogen reduction technologies (PRTs) and other participants from Blood centers, academia, and industry gathered at the Food and Drug Administration (FDA) White Oak Campus in Silver Spring, Maryland, for a 2‐day public workshop entitled “Pathogen Reduction Technologies for Blood Safety.” The workshop opened with welcome remarks from Dr. Nicole Verdun, Director, Office of Blood Research and Review (OBRR), Center for Biologics Evaluation and Research (CBER), FDA, followed by introductory remarks from Dr. Peter Marks, Director, CBER, FDA. The first day of the workshop focused on Blood‐borne infectious agents and their impact on Blood Safety, experiences of the American Red Cross, and other Blood establishments in implementing FDA‐approved pathogen inactivation (PI) technology for plasma and platelets (PLTs) in the United States and novel PRTs under consideration for whole Blood (WB) and red Blood cells (RBCs). The second day opened with welcome remarks from Dr. Chintamani Atreya, Associate Director for Research, OBRR, CBER, FDA. The focus was on emerging innovations relevant to PRTs and potential alternatives to PRTs. The workshop concluded with remarks on insights for future research and development in this area for Blood and Blood product Safety from infectious agents. A brief introduction of each session by the session moderator followed by a summary of the speaker presentation as submitted by the moderator and speaker are reported here.
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screening of Blood donations for zika virus infection puerto rico april 3 june 11 2016
Morbidity and Mortality Weekly Report, 2016Co-Authors: Matthew J Kuehnert, Michael P. Busch, Phillip C Williamson, Sridhar V Basavaraju, Robin R Moseley, Lisa L Pate, Susan A Galel, Jose Alsina, Consuelo Climentperis, Peter W MarksAbstract:Transfusion-transmitted infections have been documented for several arboviruses, including West Nile and dengue viruses (1). Zika virus, a flavivirus transmitted primarily by Aedes aegypti mosquitoes that has been identified as a cause of congenital microcephaly and other serious brain defects (2), became recognized as a potential threat to Blood Safety after reports from a 2013-2014 outbreak in French Polynesia. Blood Safety concerns were based on very high infection incidence in the population at large during epidemics, the high percentage of persons with asymptomatic infection, the high proportion of Blood donations with evidence of Zika virus nucleic acid upon retrospective testing, and an estimated 7-10-day period of viremia (3). At least one instance of transfusion transmission of Zika virus has been documented in Brazil after the virus emerged there, likely in 2014 (4). Rapid epidemic spread has followed to other areas of the Americas, including Puerto Rico.
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emerging infectious agents and the nation s Blood supply responding to potential threats in the 21st century
Transfusion, 2013Co-Authors: Simone A Glynn, Michael P. Busch, Steven Kleinman, Roger Y Dodd, Louis M Katz, S L Stramer, Harvey G Klein, Graham Simmons, Susan B ShurinAbstract:In the early 1990s, the Department of Health and Human Services (DHHS) asked the Institute of Medicine (IOM) to assess how the government, the private sector, and other stakeholders had responded to the human immunodeficiency virus (HIV) epidemic and its impact on Blood Safety. In its executive summary published in TRANSFUSION,1 the IOM Committee to Study HIV Transmission Through Blood and Blood Products noted that although stakes were high, decisions had to be made under a cloud of uncertainty and that responses were slowed by imprecise and incomplete knowledge, personal and institutional biases, and ultimately by failures in leadership. Emphasizing that Blood Safety is a shared responsibility, the IOM Committee issued 14 recommendations related to structure and policy including the designation of a Blood Secretary Director by DHHS, the establishment of a Blood Safety Council by the US Public Health Service (PHS), and several recommendations to the Federal agencies involved in the evaluation of an infectious threat, in particular, the Food and Drug Administration (FDA). Since then, these recommendations have been implemented and the Blood Safety community (Blood collectors, Blood Safety experts, and relevant Federal agencies) has responded to other emerging infectious disease (EID) threats, such as West Nile virus (WNV) and most recently the xenotropic murine leukemia virus–related virus (XMRV). Responding to any new threat entails assessing the risk to the Blood supply and recipients’ health; evaluating how best to manage and/or control each potential risk; and communicating this information to Blood donors, recipients, physicians, and the general public. Although the FDA has the regulatory authority to develop guidance documents and new regulations in response to EID threats based on available data, the challenge of generating that data and responding to potential risks requires concerted and coordinated actions by the multiple PHS agencies (Centers for Disease Control and Prevention [CDC], FDA, National Institutes of Health [NIH]) and by the broader transfusion medicine community (AABB and Blood providers). It is therefore incumbent upon the transfusion medicine professionals to collect and provide robust data in a timely manner to policymakers to inform their decision process, as well as take an active role in risk communication. All stakeholders must recognize what they can do and provide leadership and timely research and risk assessments. In so doing, they must take a hard look at their responses and learn lessons from history. Such a process does not involve a confirmation or criticism of what has been done in previous responses to potential threats to the Blood supply, but an assessment of how responses can be improved for future threats. In the aftermath of the recent XMRV investigation and the inevitable occurrence of future infectious threats, the National Heart, Lung, and Blood Institute (NHLBI) convened an expert task force charged with evaluating how lessons from previous EID Blood Safety threat assessments could be used to optimize future response strategies. The task force was asked to review and discuss responses to past epidemics and recent EIDs and to consider: What worked? What could have worked better? What data are necessary to assess Blood Safety risk? Who needs to be engaged in the evaluation of risk; that is, who are the stakeholders? What methods and/or processes need to be in place and when? What resources, infrastructure, and capacity are needed? How best to train future experts? And how can a scientific culture be encouraged that encourages cooperation? In a first session, responses to earlier epidemics were examined, followed by a discussion on responses to recent agents of concern, including an in-depth look at the latest potential threat, XMRV. A general overview of other agents of potential concerns (the horizon) ensued followed by a general discussion on lessons learned and consideration of future strategies. This report summarizes the results of these discussions.
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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 Blood xenotropic murine leukemia virus related virus scientific research working group mission progress and plans
Transfusion, 2011Co-Authors: Graham Simmons, Simone A Glynn, Jerry A Holmberg, John M Coffin, Indira Hewlett, Judy A Mikovits, William M Switzer, Jeffrey M Linnen, Michael P. BuschAbstract:Recently, there have been studies that indicate that Xenotropic Murine Leukemia Virus (MLV)-related Virus (XMRV), a newly described human gammaretrovirus, and other related viruses, may be associated with both prostate cancer and myalgic encephalomyelitis (ME) / chronic fatigue syndrome (CFS)1–4. It has also been suggested that these viruses have the potential to be transmitted by Blood transfusion5. However, a number of studies have failed to support these associations, or indeed detect significant evidence of XMRV in the human population6–9. Currently, there is insufficient information to determine whether or not XMRV and related viruses are a threat to Blood Safety. Accordingly, the Department of Health and Human Services (HHS) has established a Scientific Research Working Group (SRWG) to explore the following questions: What is the prevalence of XMRV in the donor population? Is XMRV transmissible by Blood transfusion? And if XMRV is transmissible by transfusion, are there any pathologic consequences for the infected recipient? As a starting point, the SRWG has focused on standardizing the various tests used to detect XMRV in Blood samples and has facilitated the sharing of clinical samples between laboratories. This commentary discusses background information relating to Blood Safety and XMRV and related viruses and outlines the specific actions that the SRWG has taken and plans to take.
Matthew J Kuehnert - One of the best experts on this subject based on the ideXlab platform.
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survey of Blood collection centers and implementation of guidance for prevention of transfusion transmitted zika virus infection puerto rico 2016
American Journal of Transplantation, 2016Co-Authors: Amber Vasquez, Matthew J Kuehnert, Sridhar V Basavaraju, Mathew R P Sapiano, Brenda RiveragarciaAbstract:Since November 2015, Puerto Rico has reported active mosquito-borne transmission of Zika virus. Because of the potential for Zika virus to be transmitted through transfusion of Blood components, and because a high percentage of persons infected with Zika virus are asymptomatic, the Food and Drug Administration (FDA) recommended that Blood collections cease in areas of the United States affected by active vector-borne transmission of Zika virus until laboratory screening of Blood donations or pathogen reduction technology (PRT) for treatment of Blood components can be implemented. To inform efforts to maintain the Safety and availability of the Blood supply in Puerto Rico, CDC, in collaboration with the Puerto Rico Department of Health, conducted a rapid assessment of Blood collection and use on the island. A total of 139,369 allogeneic red Blood cell (RBC) units, 45,243 platelet units, and 56,466 plasma units were collected in or imported to Puerto Rico during 2015, and 135,966 allogeneic RBC units, 13,526 therapeutic platelet units, and 25,775 plasma units were transfused. Because of the potential for local Zika virus transmission in areas with a competent mosquito vector, other areas of the United States should develop plans to ensure local Blood Safety and adequacy. Blood collection organizations and public health agencies should collaborate to maintain the Safety and availability of local Blood supplies in accordance with FDA guidance.
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screening of Blood donations for zika virus infection puerto rico april 3 june 11 2016
Morbidity and Mortality Weekly Report, 2016Co-Authors: Matthew J Kuehnert, Michael P. Busch, Phillip C Williamson, Sridhar V Basavaraju, Robin R Moseley, Lisa L Pate, Susan A Galel, Jose Alsina, Consuelo Climentperis, Peter W MarksAbstract:Transfusion-transmitted infections have been documented for several arboviruses, including West Nile and dengue viruses (1). Zika virus, a flavivirus transmitted primarily by Aedes aegypti mosquitoes that has been identified as a cause of congenital microcephaly and other serious brain defects (2), became recognized as a potential threat to Blood Safety after reports from a 2013-2014 outbreak in French Polynesia. Blood Safety concerns were based on very high infection incidence in the population at large during epidemics, the high percentage of persons with asymptomatic infection, the high proportion of Blood donations with evidence of Zika virus nucleic acid upon retrospective testing, and an estimated 7-10-day period of viremia (3). At least one instance of transfusion transmission of Zika virus has been documented in Brazil after the virus emerged there, likely in 2014 (4). Rapid epidemic spread has followed to other areas of the Americas, including Puerto Rico.
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west nile virus infection transmitted by Blood transfusion
Transfusion, 2003Co-Authors: Theresa Harrington, Matthew J Kuehnert, Hany Kamel, Robert S Lanciotti, Sheryl Hand, Mary Currier, Mary E Chamberland, Lyle R Petersen, Anthony A MarfinAbstract:BACKGROUND: A patient with transfusion-transmitted West Nile virus (WNV) infection confirmed by viral culture of a Blood component is described. A 24-year-old female with severe postpartum hemorrhage developed fever, chills, headache, and generalized malaise after transfusion of 18 units of Blood components; a serum sample and the cerebrospinal fluid tested positive for the presence of WNV IgM antibodies. An investigation was initiated to determine a possible association between transfusion and WNV infection. STUDY DESIGN AND METHODS: Blood donors were assessed for recent infection through questionnaires and WNV testing of serum samples. Whole-Blood retention segments and untransfused Blood components were sent to the CDC to test for the presence of WNV through PCR (TaqMan, Applied Biosystems), IgM ELISA, plaque reduction neutralization testing, and viral culture. RESULTS: Three of 15 available donor retention segments were WNV PCR-positive. WNV was recovered from one associated Blood component. The implicated donor was symptomatic near the time of donation; serology confirmed WNV IgM seroconversion. CONCLUSION: Seroconversion of a symptomatic donor, the presence of viral genetic material in an associated whole-Blood retention segment, and recovery of WNV from an associated component provides compelling evidence for transfusion-acquired infection. This report has important implications for Blood Safety.
Daniel Candotti - One of the best experts on this subject based on the ideXlab platform.
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hepatitis b virus hbv infection and recombination between hbv genotypes d and e in asymptomatic Blood donors from khartoum sudan
Journal of Clinical Microbiology, 2011Co-Authors: Shaza Mahgoub, Daniel Candotti, Magdy El Ekiaby, Jeanpierre AllainAbstract:Sudan is a highly endemic area for hepatitis B virus (HBV), and >5% of Blood donors are chronically infected. To examine potential strategies to improve HBV Blood Safety, 404 replacement donor samples previously screened for HBV surface antigen (HBsAg) were tested for antibody to HBV core (anti-HBc), anti-surface antigen (anti-HBs), and HBV DNA. Of 145 anti-HBc-containing samples (36%) identified, 16 retested were HBsAg positive (11%). Anti-HBs was detected in 43/77 (56%) anti-HBc-reactive samples. Six samples were HBsAg−/anti-HBc+/anti-HBs+ and contained HBV DNA, meeting the definition of occult HBV infection (OBI). OBIs had low HBV DNA loads (<10 IU/ml) and were genotype B (n = 1) or genotype D (n = 5). Pre-S/S and/or whole genome sequences were obtained from 47 randomly selected HBsAg-positive donors added to the previous 16. Genotype E was identified in 27 strains (57.5%), genotype D in 19 strains (40.5%), and genotype A2 in 1 strain (2%). Two outlier strains within genotype D ultimately were identified as recombinants of genotypes D and E with identical recombination points, suggesting circulating, infectious, recombinant strains. Anti-HBc screening does not appear to be a sustainable Blood Safety strategy because of the cost and the negative impact on the Sudanese Blood supply, even when reduced by anti-HBs testing. Being at the junction between two main African HBV genotypes, genetic recombination occurred and became part of the molecular epidemiology of HBV in Sudan.
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hepatitis b virus hbv infection and recombination between hbv genotypes d and e in asymptomatic Blood donors from khartoum sudan
Journal of Clinical Microbiology, 2011Co-Authors: Shaza Mahgoub, Daniel Candotti, Magdy El Ekiaby, Jeanpierre AllainAbstract:ABSTRACT Sudan is a highly endemic area for hepatitis B virus (HBV), and >5% of Blood donors are chronically infected. To examine potential strategies to improve HBV Blood Safety, 404 replacement donor samples previously screened for HBV surface antigen (HBsAg) were tested for antibody to HBV core (anti-HBc), anti-surface antigen (anti-HBs), and HBV DNA. Of 145 anti-HBc-containing samples (36%) identified, 16 retested were HBsAg positive (11%). Anti-HBs was detected in 43/77 (56%) anti-HBc-reactive samples. Six samples were HBsAg−/anti-HBc+/anti-HBs+ and contained HBV DNA, meeting the definition of occult HBV infection (OBI). OBIs had low HBV DNA loads (
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characterization of occult hepatitis b virus from Blood donors carrying genotype a2 or genotype d strains
Journal of Hepatology, 2008Co-Authors: Daniel Candotti, Robert Crookes, Piotr Grabarczyk, Paola Ghiazza, Roberto Roig, Natalia Casamitjana, Paola Iudicone, Michael Schmidt, Arthur Bird, Ewa BrojerAbstract:Background/Aims Nucleic acid testing (NAT) for hepatitis B virus (HBV) DNA in Blood donations identified occult HBV infection (OBI) as a potential threat to Blood Safety. Methods A collaborative study was undertaken to explore the molecular basis of OBIs prevalent in Europe in relation to clinical and serological data. Results Ninety-one percent of 77 donor samples of European origin HBV DNA positive but HBV surface antigen (HBsAg) negative were confirmed. Viral load ranged between unquantifiable and 5640IU/mL (median 25IU/mL). Fifty-two strains were genotyped (14 HBV A2 and 38 HBV D ). Compared to HBsAg+ samples, genotype D was significantly more frequent than genotype A2 in OBIs from Poland or Italy ( P P P P P P Conclusions Results support the hypothesis that humoral and cellular immune pressure on the HBV envelope proteins are major mechanisms generating OBI.
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predonation screening of Blood donors with rapid tests implementation and efficacy of a novel approach to Blood Safety in resource poor settings
Transfusion, 2005Co-Authors: Shirley Owusuofori, Francis Sarkodie, Daniel Candotti, Jillian Temple, Margaret Anokwa, Jeanpierre AllainAbstract:BACKGROUND: In sub-Saharan Africa, the percentage of screened Blood is limited to approximately 75 percent for human immunodeficiency virus antibodies (anti-HIV), 50 percent for hepatitis B surface antigen, and 19 percent for hepatitis C virus antibodies (anti-HCV), mainly because of costs. STUDY DESIGN AND METHODS: In 2002 to 2003, candidate Blood donors were screened before donation for HIV, HCV, and hepatitis B virus (HBV) serologic markers with rapid tests. The efficacy of this screening was assessed by nucleic acid testing (NAT) applied to pools of 10 plasma samples from donated units with a virus specific triplex assay. NAT-reactive pools were resolved by viral genome identification in individual plasma sample. Deferred candidate donors were referred to a donor-care program. RESULTS: A total of 9372 people were screened and 1534 (16.4%) were deferred. No HIV or HCV RNA–containing samples remained undetected by rapid tests unless a human testing error was involved. In contrast, 1.3 and 3.0 percent of HBV DNA–containing Blood units were negative with rapid tests but were detected in individual donations with enzyme immunoassay and genomic amplification, respectively. Only half of these units were detectable in pools of 10 samples. One-third of deferred candidate donors attended the donor-care program and were informed and counseled. CONCLUSIONS: Predonation viral screening of Blood donors is effective in high endemic areas, and the savings it generates may improve the Safety and limit the cost of Blood. Communication with deferred donors may contribute to public health. A new screening strategy associating serologic rapid test before donation and NAT on pools of 10 plasma samples after donation is proposed.