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Modeling the Risk of HIV Transfusion Transmission.
Artur Belov1, Hong Yang1, Richard A Forshee1
1Office of Biostatistics & Epidemiology, Center for Biologics Evaluation and Research, US FDA; and.
Journal of Acquired Immune Deficiency Syndromes (1999)
|October 11, 2022
Summary
A new dose-response model quantifies HIV transfusion-transmission risk from window period (WP) donations. This model aids risk assessment for blood components with low viral RNA copies, improving blood supply safety.
Area of Science:
- Virology
- Epidemiology
- Biostatistics
Background:
- Routine HIV screening of blood donations aims to prevent transmission.
- Window period (WP) donations, undetectable by current assays, pose a residual risk.
- Quantitative risk assessment models are needed for WP donations.
Purpose of the Study:
- To develop a dose-response model for HIV transfusion-transmission probability.
- To estimate the relationship between viral RNA copies and transmission risk.
- To aid quantitative risk assessment of WP blood donations.
Main Methods:
- An exponential dose-response model was selected for its data fit and parsimony.
- Data from a nonhuman primate HIV challenge study and human transfusion data were used.
- A Bayesian framework with NUTS and Monte Carlo simulations quantified parameter uncertainty.
Main Results:
- Estimated transmission probability parameters differed between animal and human models.
- The 50% infectious dose (ID50) was predicted as 26 RNA copies for the animal model and 918 for the human model.
- Credible intervals quantified the uncertainty in parameter estimates and predictions.
Conclusions:
- The developed dose-response model enables quantitative estimation of HIV transfusion-transmission risk.
- This model is valuable for assessing risks associated with WP donations, particularly those with low viral loads.
- The findings contribute to enhancing the safety of the blood supply by quantifying residual HIV transmission risks.
