Prevalence, incidence, and residual risk of major blood-borne infections among apheresis collections to the American Red Cross Blood Services, 2004 through 2008
Article first published online: 12 MAR 2010
© 2010 American Association of Blood Banks
Volume 50, Issue 7, pages 1487–1494, July 2010
How to Cite
Zou, S., Musavi, F., Notari, E. P., Stramer, S. L. and Dodd, R. Y. (2010), Prevalence, incidence, and residual risk of major blood-borne infections among apheresis collections to the American Red Cross Blood Services, 2004 through 2008. Transfusion, 50: 1487–1494. doi: 10.1111/j.1537-2995.2010.02621.x
- Issue published online: 1 JUL 2010
- Article first published online: 12 MAR 2010
- Received for publication September 11, 2009; revision received December 29, 2009, and accepted January 16, 2010.
BACKGROUND: The number of apheresis collections increased significantly in recent years; however, data on viral marker rates among these collections are lacking.
STUDY DESIGN AND METHODS: Apheresis collection data for 2004 to 2008 were analyzed. All collections were tested for antibodies and viral RNA for human immunodeficiency virus (HIV) and hepatitis C virus (HCV), hepatitis B surface antigen (HBsAg), antibody to hepatitis B core antigen (anti-HBc), antibody to human T-lymphotropic virus (anti-HTLV), and other markers. HBsAg-confirmed-positive but anti-HBc–nonreactive units were further verified by HBV DNA testing.
RESULTS: From 2004 to 2008, apheresis collections for double red blood cells (R2) increased by 294% to a total of 37% of all apheresis collections. Marker rates (/100,000) among all apheresis collections were 1.41, 7.83, 2.04, and 0.28, for HIV, HCV, HBsAg, and HTLV. Among R2 collections, rates (/100,000) were 6- to 13-fold higher than among non-R2 collections for HIV (3.50 vs. 0.53), HCV (21.84 vs. 1.96), and HBsAg (5.83 vs. 0.44), but not HTLV (0.53 vs. 018). First-time male R2 donors accounted for 25% to 100% of positivity but only 1% to 5% of the total number of apheresis collections. Incidence (/100,000 person-years) and residual risk estimates among repeat apheresis donors between 2007 and 2008 for HIV were 3.82 and 1:1.0 million, for HCV were 1.53 and 1:3.2 million, and for HBsAg were 4.85 and 1:200,000. These estimates were comparable to those among repeat whole blood donors.
CONCLUSION: The risk of major blood-borne infections among current apheresis collections was low; however, an upward trend in the viral marker frequency among apheresis donations was attributable to the contribution of first-time, male R2 donors.