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Residual risk of HIV, HCV and HBV in Canada

Sheila F O'Brien1, Qi-Long Yi1, Wenli Fan2

  • 1Canadian Blood Services, Canada; Dept. of Epidemiology & Community Medicine, University of Ottawa, Canada.

Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis
|April 9, 2017
PubMed
Abstract

Insights

The residual risk of blood donation infections from HIV, HCV, and HBV remains very low, with updated testing methods ensuring continued blood safety. Further reductions in the infectious window period offer minimal quantifiable safety benefits.

Area of Science:

  • Blood Transfusion Safety
  • Infectious Disease Epidemiology
  • Virology

Background:

  • Residual risk in blood donations is calculated by incidence and infectious window period.
  • Nucleic acid multiplex testing (MPX) was implemented in 2011, including hepatitis B (HBV) NAT alongside HIV-1 and hepatitis C (HCV).

Purpose of the Study:

  • To estimate window period risk-day equivalents for MPX.
  • To update residual risk estimates for viral infections in blood donations.

Main Methods:

  • Incidence of HIV, HCV, and HBV was estimated from repeat donations (2012-2014).
  • Window period risk-day equivalents for MPX were calculated using a published method.
  • Residual risk was determined by multiplying incidence and window period risk-day equivalents.

Main Results:

  • Incidence rates per 100,000 person-years: HIV 0.28, HCV 1.0, HBV 0.26.
  • Residual risk: HIV 1 in 21.4 million, HCV 1 in 12.6 million, HBV 1 in 7.5 million donations.

Conclusions:

  • The residual risk of viral infection in blood donations is very low.
  • Current safety levels are comparable to those observed between 2006-2009.
  • The safety benefit of further reducing the infectious window period is below quantifiable thresholds.
Keywords:
IncidenceMultiplex NATResidual risk

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