Current incidence and estimated residual risk of transfusion-transmitted infections in donations made to Canadian Blood Services

  1. Sheila F. O'Brien,
  2. Qi-Long Yi,
  3. Wenli Fan,
  4. Vito Scalia,
  5. Steven H. Kleinman,
  6. Eleftherios C. Vamvakas

Article first published online: 11 JAN 2007

DOI: 10.1111/j.1537-2995.2007.01108.x

Issue

Transfusion

Transfusion

Volume 47, Issue 2, pages 316–325, February 2007

Additional Information

How to Cite

O'Brien, S. F., Yi, Q.-L., Fan, W., Scalia, V., Kleinman, S. H. and Vamvakas, E. C. (2007), Current incidence and estimated residual risk of transfusion-transmitted infections in donations made to Canadian Blood Services. Transfusion, 47: 316–325. doi: 10.1111/j.1537-2995.2007.01108.x

Author Information

  1. From the Canadian Blood Services, and the Departments of Epidemiology & Community Medicine and Pathology & Laboratory Medicine, University of Ottawa, Ottawa, Ontario; and the Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada.

*Sheila F. O'Brien, National Epidemiology and Surveillance, Canadian Blood Services, 1800 Alta Vista Drive, Ottawa, ON, Canada K1G 4J5; e-mail: sheila.o'brien@bloodservices.ca.

Publication History

  1. Issue published online: 22 JAN 2007
  2. Article first published online: 11 JAN 2007
  3. Received for publication May 11, 2006; revision received July 17, 2006, and accepted July 21, 2006.

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BACKGROUND: New testing methods such as nucleic acid amplification testing (NAT) and chemiluminescent serologic assays have been introduced, more precise estimates for infectious window periods are available, and a new method for estimating the residual risk (RR) of transfusion-transmitted infections (TTIs) has been developed. Thus, available RR estimates for Canada need to be updated.

STUDY DESIGN AND METHODS: Incidence rates for known TTI markers were determined for all allogeneic whole-blood donations made to Canadian Blood Services between 2001 and 2005; they were derived from NAT conversions or seroconversions of repeat donors with at least two donations in a 3-year period. RR estimates for human immunodeficiency virus (HIV)-1 and hepatitis C virus (HCV) derived from the classical incidence/window-period model were compared to those obtained by the new method that estimates incidence from NAT-positive, antibody-negative donations (NAT-yield cases) from all donors divided by person-years.

RESULTS: With the classical method, the RR of HIV (1 per 7.8 million donations) and HCV (1 per 2.3 million) were low; HBV RR was higher (1 per 153,000). HCV RR was significantly lower when estimated with the new method (1 per 13 million). Eleven HCV NAT-yield cases were predicted by applying the classical method to our seroconversion data but only 2 were observed (p = 0.011). Observed HIV-1 NAT-yield cases (n = 1) matched those predicted (n = 0.7).

CONCLUSION: New tests have reduced an already low risk of TTI in Canada. HCV RR estimates by two different methods differed but both were low.

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