Prevalence, incidence, and residual risks for transfusion-transmitted human immunodeficiency virus Types 1 and 2 infection among Chinese blood donors

Authors

  • Jingxing Wang,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. The Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Yunnan Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang
    5. Guangxi Blood Center, Liuzhou, Guangxi, P.R. China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    8. Westat, Inc., Rockville, Maryland
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  • Jing Liu,

    Corresponding author
    1. The Johns Hopkins Medical Institutions, Baltimore, Maryland
    2. Yunnan Kunming Blood Center, Kunming, Yunnan, P.R. China
    3. Urumqi Blood Center, Urumqi, Xinjiang
    4. Guangxi Blood Center, Liuzhou, Guangxi, P.R. China
    5. Luoyang Blood Center, Luoyang, Henan, P.R. China
    6. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    7. Westat, Inc., Rockville, Maryland
    • Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
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  • Fuzhu Yao,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. The Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Yunnan Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang
    5. Guangxi Blood Center, Liuzhou, Guangxi, P.R. China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    8. Westat, Inc., Rockville, Maryland
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  • Guoxin Wen,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. The Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Yunnan Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang
    5. Guangxi Blood Center, Liuzhou, Guangxi, P.R. China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    8. Westat, Inc., Rockville, Maryland
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  • Julin Li,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. The Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Yunnan Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang
    5. Guangxi Blood Center, Liuzhou, Guangxi, P.R. China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    8. Westat, Inc., Rockville, Maryland
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  • Yi Huang,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. The Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Yunnan Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang
    5. Guangxi Blood Center, Liuzhou, Guangxi, P.R. China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    8. Westat, Inc., Rockville, Maryland
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  • Yunlai Lü,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. The Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Yunnan Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang
    5. Guangxi Blood Center, Liuzhou, Guangxi, P.R. China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    8. Westat, Inc., Rockville, Maryland
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  • Xiuqiong Wen,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. The Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Yunnan Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang
    5. Guangxi Blood Center, Liuzhou, Guangxi, P.R. China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    8. Westat, Inc., Rockville, Maryland
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  • David Wright,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. The Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Yunnan Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang
    5. Guangxi Blood Center, Liuzhou, Guangxi, P.R. China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    8. Westat, Inc., Rockville, Maryland
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  • Qilu Yu,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. The Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Yunnan Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang
    5. Guangxi Blood Center, Liuzhou, Guangxi, P.R. China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    8. Westat, Inc., Rockville, Maryland
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  • Nan Guo,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. The Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Yunnan Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang
    5. Guangxi Blood Center, Liuzhou, Guangxi, P.R. China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    8. Westat, Inc., Rockville, Maryland
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  • Paul Ness,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. The Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Yunnan Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang
    5. Guangxi Blood Center, Liuzhou, Guangxi, P.R. China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    8. Westat, Inc., Rockville, Maryland
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  • Hua Shan,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. The Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Yunnan Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang
    5. Guangxi Blood Center, Liuzhou, Guangxi, P.R. China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    8. Westat, Inc., Rockville, Maryland
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  • and for the NHLBI Retrovirus Epidemiology Donor Study-II (REDS-II) and International Component


Address reprint requests to: Jing Liu, PhD, The Johns Hopkins Medical Institutions, 600 N. Wolfe Street, Baltimore, MD 21287; e-mail: jliu84@jhmi.edu.

Abstract

Background

There are little data on human immunodeficiency virus (HIV) prevalence, incidence, or residual risks for transfusion-transmitted HIV infection among Chinese blood donors.

Study Design and Methods

Donations from five Chinese blood centers in 2008 to 2010 were screened using two rounds of enzyme-linked immunosorbent assay for anti-HIV-1/2. A reactive result in either or both rounds led to Western blot confirmatory testing. HIV prevalence among first-time donors and incidence among repeat donors were examined. Weighted multivariable logistic regression analysis examined correlates of HIV confirmatory status among first-time donors. Residual risks were evaluated based on incidence among repeat donors.

Results

Among 821,320 donations, 40% came from repeat donors. A total of 1837 (0.34%) first-time and 577 (0.17%) repeat donations screened reactive, among which 1310 and 419 were tested by Western blot. A total of 233 (17.7%) first-time and 44 (10.5%) repeat donations were confirmed positive. Prevalence was 66 infections per 100,000 (95% confidence interval [CI], 59-74) first-time donors. Incidence was 9 of 100,000 (95% CI, 7-12) person-years among repeat donors. Multivariable logistic regression analysis indicates that first-time donors 26 to 45 years old were 1.6 to 1.8 times likely to be HIV positive than those 25 years and younger. Donors with some college or above education were less likely to be HIV positive than those with middle school education, odds ratios (ORs) ranging from 0.35 to 0.60. Minorities were 1.5 times likely to be HIV positive than Han majority donors (OR, 1.6; 95% CI, 1.2-2.1). HIV residual risk was 5.4 (95% CI, 1.2-12.5) infections per million whole blood donations.

Conclusion

Despite the declining HIV epidemic in China, estimated residual risks for transfusion-transmitted HIV infection are still high.

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