Window period donations during primary cytomegalovirus infection and risk of transfusion-transmitted infections

Authors

  • Malte Ziemann,

    Corresponding author
    1. Institute for Transfusion Medicine of Hannover Medical School, Hannover, Germany
    2. German Red Cross Blood Donor Service East, Plauen, Germany
    3. German Red Cross Blood Donor Service North, Lütjensee, Germany
    • Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany
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  • Hans-Gert Heuft,

    1. Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany
    2. Institute for Transfusion Medicine of Hannover Medical School, Hannover, Germany
    3. German Red Cross Blood Donor Service East, Plauen, Germany
    4. German Red Cross Blood Donor Service North, Lütjensee, Germany
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  • Kerstin Frank,

    1. Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany
    2. Institute for Transfusion Medicine of Hannover Medical School, Hannover, Germany
    3. German Red Cross Blood Donor Service East, Plauen, Germany
    4. German Red Cross Blood Donor Service North, Lütjensee, Germany
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  • Sabine Kraas,

    1. Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany
    2. Institute for Transfusion Medicine of Hannover Medical School, Hannover, Germany
    3. German Red Cross Blood Donor Service East, Plauen, Germany
    4. German Red Cross Blood Donor Service North, Lütjensee, Germany
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  • Siegfried Görg,

    1. Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany
    2. Institute for Transfusion Medicine of Hannover Medical School, Hannover, Germany
    3. German Red Cross Blood Donor Service East, Plauen, Germany
    4. German Red Cross Blood Donor Service North, Lütjensee, Germany
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  • Holger Hennig

    1. Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany
    2. Institute for Transfusion Medicine of Hannover Medical School, Hannover, Germany
    3. German Red Cross Blood Donor Service East, Plauen, Germany
    4. German Red Cross Blood Donor Service North, Lütjensee, Germany
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Address reprint requests to: Malte Ziemann, Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Ratzeburger Allee 160, 23538 Lübeck, Germany; e-mail: Malte.Ziemann@uk-sh.de.

Abstract

Background

Donors with short interdonation intervals (e.g., apheresis donors) have an increased risk of window period donations. The frequency of cytomegalovirus (CMV) window period donations is important information to decide whether selection of seronegative donors might be advantageous for patients at risk for transfusion-transmitted CMV infections (TT-CMV).

Study Design and Methods

CMV seroconversion in 93 donors with positive results in routine CMV antibody testing within at most 35 days after the last seronegative sample was evaluated by Western blot and/or a second antibody test. In donors with unconfirmed seroconversion, an additional later sample was tested. Concentration of CMV DNA was determined in pre- and postseroconversion samples.

Results

CMV seroconversion was confirmed in 12 donors (13%). Among these, the last seronegative sample was CMV DNA positive in three donors (25%, below 30 IU/mL). The first seropositive sample was CMV DNA positive in 10 donors (83%, maximum 1600 IU/mL). Both prevalence and median concentration of CMV DNA were higher in the first seropositive sample (p = 0.004 and p = 0.02), with maximum concentrations being reached about 2 weeks after seroconversion. No CMV DNA was detected in samples from donors with unconfirmed seroconversion.

Conclusion

At least in donors with short interdonation intervals, most suspected CMV seroconversions are due to false-positive results of the screening test. As window period donations are rare and contain less CMV DNA than the first seropositive donation, avoidance of blood products from primarily seropositive donors is especially helpful to avoid TT-CMV if donors with short interdonation intervals are concerned.

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