Abstract
Background: The prevalence of infection by Toxoplasma gondii is high worldwide and different routes of transmission of this parasite are known. Among them, the use of blood products collected from blood donors at the acute infection has been appointed as one of the causes of transfusional transmission of T. gondii. However, measurements of the risk of transfusional transmission of T. gondii by blood products are scarce. The aim of this study was to estimate the risk of transfusional transmission of T. gondii from blood products. Methods & Materials: Blood samples from 1.729 blood donors able to donation were screened by serology to identify anti-T. gondii antibodies (ELISA IgM and IgG). Those blood donors presenting serological evidence of acute infection (IgM+/IgG-) and recent infection (IgM+/IgG+) were evaluated by ELFA and IgG avidity was determined (VIDAS system). Additionally, all blood donors were screened by Real Time PCR (qPCR) using specific primers targeting the T. gondii B1 gene. A mathematical model that considers low (one day) and high (21 days) parasitemia was applied to calculate the risk of transfusional transmission of T. gondii by blood products. Results: The prevalence of anti-T. gondii antibodies (IgM and/or IgG) was 48.3% (n = 835). From the overall blood donors, 8 (0.46%) presented IgM+/IgG- serology, and only blood products from 3 (37.5%) were used for transfusion purposes. From the overall blood donors, 30 (1.7%) presented IgM+/IgG+ serology, and only blood products from 25 (83.3%) were for transfusion purposes. All blood donors presenting IgM+/IgG+ serology confirmed by ELFA presented IgG with high avidity. The risk of transfusional transmission of T. gondii estimated from serology was 9.1 considering low parasitemia, and 260.6 considering high parasitemia, per 100.000 donations. In all cases, none of them presented evidence of parasitemia when investigated by qPCR. Conclusion: The data showed a high prevalence of infection by T. gondii among Brazilian blood donors from the northeast region of São Paulo State. According to the used mathematical model, the risk of transfusional transmission of T. gondii by blood products increases with the time of parasitemia. However, no evidence of T. gondii infecting blood products was demonstrated by qPCR.
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