Human immunodeficiency virus prevalence, incidence, and residual transmission risk in first‐time and repeat blood donations in Zimbabwe: implications on blood safety. Issue 10 (23rd June 2013)

• Record Type: Journal Article
• Authors: Mapako, Tonderai; Mvere, David A.; Chitiyo, McLeod E.; Rusakaniko, Simbarashe; Postma, Maarten J.; van Hulst, Marinus
• Is Part Of: Transfusion. Volume 53:Issue 10:Part 2(2013)
• Page Start: 2413
• Page End: 2421
• Publication Date: 2013-06-23
• Subjects: Hematology -- Periodicals; Blood -- Transfusion -- Periodicals; Blood Group Antigens -- Periodicals; Blood Preservation -- Periodicals; Blood Transfusion -- Periodicals; 615
• DOI: 10.1111/trf.12311
• Languages: English
• ISSNs: 0041-1132

Abstract

Abstract : Background: National Blood Service Zimbabwe human immunodeficiency virus (HIV) risk management strategy includes screening and discarding of first‐time donations, which are collected in blood packs without an anticoagulant (dry pack). To evaluate the impact of discarding first‐time donations on blood safety the HIV prevalence, incidence, and residual risk in first‐time and repeat donations (wet packs) were compared. Study Design and Methods: Donor data from 2002 to 2010 were retrieved from a centralized national electronic donor database and retrospectively analyzed. Chi‐square test was used to compare HIV prevalence with relative risk (RR), and the RR point estimates and 95% confidence interval (CI) are reported. Trend analysis was done using Cochran‐Armitage trend test. HIV residual risk estimates were determined using published residual risk estimation models. Results: Over the 9 years the overall HIV prevalence estimates are 1.29% (n = 116, 058) and 0.42% (n = 434, 695) for first‐time and repeat donations, respectively. The overall RR was 3.1 (95% CI, 2.9‐3.3; p < 0.0001). The overall mean residual transmission risk of HIV window phase donations in first‐time was 1:7384 (range, 1:11, 308‐1:5356) and in repeat donors it was 1:5496 (range, 1:9943‐1:3347). Conclusion: The significantly high HIV prevalence estimates recorded in first‐time over repeat donations is indicative of the effectiveness of the HIV risk management strategy. However, comparable residual transmission risk estimates in first‐time and repeat donors point to the need to further review the risk management strategies. Given the potential wastage of valuable resources, future studies should focus on the cost‐effectiveness and utility of screening and discarding first‐time donations.