Seropositive Blood Research Articles

Low Prevalence of Occult Hepatitis B Infection Among Blood Donors in Beirut, Lebanon: Reconsider the Deferral Strategy of Anti-HBc Positive Blood Donors

Background: Hepatitis B virus (HBV) infection remains one of the major infectious threats to human health. Since the implementation of highly sensitive HBV nucleic acid testing, occult HBV infection (OBI) has been detected. Occult HBV infection is characterized by a positive HBV DNA test with undetectable HBsAg (Hepatits B surface antigen). The prevalence of OBI varies significantly between geographic areas, genotypes, and population depending on the sensitivity of the detection assays used. Objectives: This project aimed at determining the prevalence of OBI in blood donors from a major blood donor center in Beirut, Lebanon through testing for 4 HBV markers (HBsAg, anti-HBs, anti-HBc and HBV DNA). Methods: A total of 7437 blood donors were first tested for anti-HBc marker between August 2013 and March 2015; samples positive for anti-HBc were tested for other serological markers and HBV genome. DNA was extracted from 500 μL of plasma and tested for HBV DNA using Artus HBV TM PCR Kit assay. All anti-HBc positive samples were tested by nested PCR, targeting the S gene. Results: This study revealed a 4.6% prevalence of anti-HBc positive blood donors (341/7437). Among anti-HBc positive blood donors, 21 were HBsAg positive (6.2%) and 75% were positive for anti-HBs. The occurrence of occult hepatitis B virus in healthy seropositive blood donors during a 20 month period was very low; only 1 Syrian blood donor (n = 1/341, 0.3%) was HBsAg negative, HBV DNA-positive with anti-HBs level > 1000 mIU/mL. Conclusions: Our study indicates that HBV DNA is present in a small percentage of HBsAg negative, anti-HBc reactive units. Lebanon has developed its own blood screening strategy, which is to screen for anti-HBc in addition to HBsAg. This is based on HBV prevalence and cost-effectiveness of testing methods. The disadvantage of not implementing nucleic acid testing (NAT) is missing rare blood units from donors in the window period.

Prevalence of Trypanosoma Cruzi antibodies in blood donors from the Sao Paulo State, Brazil, between 2012 and 2014.

American tripanosomiasis (Chagas disease), the second most neglected disease in the world, is caused by the protozoan parasite Trypanosoma cruzi. Though natural transmission by insect vectors has been controlled, there is significant risk of T. cruzi transmission by blood transfusion in non-endemic regions, generally due to immigration processes from endemic areas. The objective of this study was to evaluate anti-T. cruzi seroprevalence in blood donors from the western part of São Paulo State, Brazil, by serologic and immunofluorescence confirmation tests for the period between 2012 and 2014. Currently, this region is regarded as a non-endemic area for Chagas disease. The confirmed overall T. cruzi seroprevalence among blood donors was 0.10%, which can be considered low compared to other Brazilian regions. Nevertheless, the distribution of the anti-T. cruzi antibodies within the examined region was uneven, and some areas of significantly higher prevalence were observed. We could consider two tendencies in the prevalence of T. cruzi: (i) residual older undiagnosed cases from São Paulo State, and (ii) immigration from endemic Brazilian or South American regions. The discordance obtained for T. cruzi prevalence by serologic and immunofluorescence methods demonstrates that more specific routine diagnosis is needed to diminish the cost of the assays and the loss of blood supply once all seropositive blood bags are immediately discarded.

Seroprevalence of anti-WNV IgG antibodies and WNV-RNA in Egyptian blood donors.

Transmission of West Nile virus (WNV) from asymptomatic donors has been reported during blood transfusions and organ transplants in humans. In this work, we aimed to investigate the presence of WNV antibody and WNV RNA in blood donors to evaluate the sero-prevalence of WNV and risk for WNV transmission. One hundred and sixty blood donors were tested for the presence of anti-WNV IgG by ELISA and for WNVs 1 and 2 RNA by RT-PCR. About 55% of blood donors were seropositive for WNV IgG antibodies, with significantly higher percentage of positive donors coming from rural areas and Nile Delta region compared to other donors. Using RT-PCR all donors were negative for viral RNA of both WNV lineages 1 and 2. High sero-prevelance of WNV antibodies in asymptomatic blood donors denotes endemicity of the WNV in Egypt and points to the importance of routine screening of blood donors for WNV RNA. On the other hand the absence of WNV RNA by RT-PCR indicates apparent low risk of the blood products as regards WNV transmission. Further studies into significance of WNV seronegativity among Rh negative donors and into the use of WNV seropositive blood in prophylaxis or treatment of WNV neuroinvasive disease are recommended. J. Med. Virol. 89:1323-1329, 2017. © 2017 Wiley Periodicals, Inc.

Likely Autochthonous Transmission of Trypanosoma cruzi to Humans, South Central Texas, USA.

Chagas disease, caused by Trypanosoma cruzi, is a major neglected tropical disease affecting the Americas. The epidemiology of this disease in the United States is incomplete. We report evidence of likely autochthonous vectorborne transmission of T. cruzi and health outcomes in T. cruzi–seropositive blood donors in south central Texas, USA.

Significant variations in the seroprevalence of C6 ELISA antibodies in a highly endemic area for Lyme borreliosis: evaluation of age, sex and seasonal differences.

The purpose of this study was to assess the seroprevalence of C6 ELISA antibodies in healthy blood donors in Kalmar County, Sweden, in relation to age, sex and time of year (peak season vs off season). In addition, we wanted to assess serological status over time in a group of C6 ELISA seropositive blood donors. Sera were collected from 273 (131 women, 142 men) blood donors in autumn 2011 and 300 (144 women, 156 men) in winter 2014. All sera were analysed in the C6 ELISA and the results were interpreted according to the manufacturer's instructions. The seroprevalence was 22% (females 16%, males 28%) in 2011 and 24% (females 15%, males 33%) in 2014. The seroprevalence was significantly higher in males and increased with age. The highest seroprevalence was observed among elderly men, 60-70 years old (46% in 2011 and 52% in 2014). No significant difference was detected in seropositivity between the samples collected in winter and autumn. All (34/34) seropositive blood donors followed over time remained seropositive at follow-up after 22-29 months. C6 ELISA seroprevalence in healthy blood donors is high in Kalmar County, thereby reducing the specificity of a positive test result regarding the clinical diagnosis of Lyme borreliosis (LB). Although C6 seroprevalence appears not to be affected by seasonal sample time, it varies greatly with age and sex. A careful evaluation of pre-test probability is therefore of the utmost importance in the clinical diagnosis of LB, especially in elderly men. We suggest that colleagues in other endemic regions also consider initiating similar evaluations to optimize the laboratory and clinical diagnosis of LB in relation to age and sex.

Seroprevalence and geographical distribution of human T-lymphotropic virus type 1 among volunteer blood donors in endemic areas of Iran

BackgroundHuman T-cell lymphotrophic virus type 1 (HTLV-1) has a worldwide distribution and it is endemic in some regions of Iran. One of the most important routes of HTLV-1 transmission is via transfusion of contaminated blood components. The risk of transmission through asymptomatic blood donors, particularly in endemic areas should be considered and appropriately managed. The main objective of this study was to determine the seroprevalence and description the geographic distribution of HTLV-1 among voluntary blood donors in Iran.MethodsThis retrospective study carried out using the data obtained from the main database of the seven blood transfusion centers of Iranian Blood Transfusion Organization between 2009 and 2013. The presence of anti-HTLV-1/2 antibodies were primarily assessed using Enzyme-linked Immunosorbent Assay. The Ab Kit assay, contain antigens for the screening of antibodies to HTLV type 1 and 2. So, it is expressed as HTLV 1/2 assay. Samples that were positive by the western blot confirmatory test were considered as definite positive HTLV-1 or HTLV-2 cases. The main socio-demographic variables were; age, gender, donation history and marital status. Descriptive and analytical statistics were used to summarize the gathered data. The chi-Square Statistical test was used to test the association between groups, P-value of less than 0.05 was considered significant.ResultsA total of 1864489 blood donations were evaluated. There were 1840 confirmed HTLV-1 positive donations (0.098%). None were positive for anti-HTLV-2. The overall HTLV-1 prevalence was 98.7 per 100,000 donations during the 5 year period. Seroprevalence was higher among females, married and older blood donors. The overall seropositivity among first time, regular and lapsed donors was, 0.29% (290/100000), 0.001% (1/100000) and 0.02% (20/100000) respectively. A significant difference was observed between regular and the first time (p <0.0001) and also between lapsed and regular blood donors (p <0.0001). Most of the HTLV-1 seropositive blood donors (175 per 100,000) were from northeastern regions. We observed a gradual decline in overall HTLV-1 prevalence during the course of the study, the prevalence rate decreased from 0.13% (130/100000) in 2009 to 0.07% (70/100000) in 2013.ConclusionsThe Seroprevalence of HTLV-1 among Iranian blood donors in the regions of our study still is considerable, but there is an obvious declining prevalence over the course of present study. Blood transfusion centers should continually evaluate the residual risk of infection in the country, especially in endemic areas.

EVALUATION OF THE ORGANIZATION OF HIV SCREENING IN SOUTHERN RUSSIA IN 2000-2016

Study objective: To evaluate the organization of HIV screening and its significance for controlling HIV/AIDS epidemic in Southern Russia. Materials: Statistical records according to the Form 4 and personal data by the Form 266u-88 related to the years 2000–2016 and the results of sentinel serologic epidemiological studies carried out by 13 territorial Centers for Prevention and Control of AIDS in Southern Russia. Methods: Raw data were treated using MS Office software and F4 and Kvik program utilities. Results: Trends to increases in the involvement of the population of Southern Russia in HIV testing and to increases in new HIV cases detection and the variabilities of these trends by regions were revealed. The prevalence of vulnerable subpopulations, including drug addicts, homo- and bisexuals, STD patients, and prisoners, was about 4%; however, they accounted for more than 25% of newly detected HIV cases. The low involvement of these subpopulations in HIV screening precludes finding out hidden HIV patient cohorts for adequate preventive and anti-epidemic interventions. Non-coherence of the results of reports by the Form 4 and of epidemiological studies with regard to seropositive blood samples suggests that the obligatory pretest counselling is inadequate for revealing the personal traits of subjects intended for HIV testing. This is another indication of the need for sentinel serologic epidemiological studies involving population groups most vulnerable to HIV. Such studies has been carried out only in three territories of Southern Russia. The data obtained in the studies show that HIV prevalence in vulnerable groups is significantly higher than HIV detection rates suggested by Form 4 reports. Measures for improving the organization of HIV screening in Southern Russia are proposed.

Influence of border disease virus (BDV) on serological surveillance within the bovine virus diarrhea (BVD) eradication program in Switzerland.

BackgroundIn 2008, a program to eradicate bovine virus diarrhea (BVD) in cattle in Switzerland was initiated. After targeted elimination of persistently infected animals that represent the main virus reservoir, the absence of BVD is surveilled serologically since 2012. In view of steadily decreasing pestivirus seroprevalence in the cattle population, the susceptibility for (re-) infection by border disease (BD) virus mainly from small ruminants increases. Due to serological cross-reactivity of pestiviruses, serological surveillance of BVD by ELISA does not distinguish between BVD and BD virus as source of infection.ResultsIn this work the cross-serum neutralisation test (SNT) procedure was adapted to the epidemiological situation in Switzerland by the use of three pestiviruses, i.e., strains representing the subgenotype BVDV-1a, BVDV-1h and BDSwiss-a, for adequate differentiation between BVDV and BDV. Thereby the BDV-seroprevalence in seropositive cattle in Switzerland was determined for the first time. Out of 1,555 seropositive blood samples taken from cattle in the frame of the surveillance program, a total of 104 samples (6.7%) reacted with significantly higher titers against BDV than BVDV. These samples originated from 65 farms and encompassed 15 different cantons with the highest BDV-seroprevalence found in Central Switzerland. On the base of epidemiological information collected by questionnaire in case- and control farms, common housing of cattle and sheep was identified as the most significant risk factor for BDV infection in cattle by logistic regression.ConclusionThis indicates that pestiviruses from sheep should be considered as a source of infection of domestic cattle and might well impede serological BVD surveillance.Electronic supplementary materialThe online version of this article (doi:10.1186/s12917-016-0932-0) contains supplementary material, which is available to authorized users.

Kampinos National Park: a risk area for spotted fever group rickettsioses, central Poland?

Ixodid ticks are important vectors of a variety of bacterial and protozoan pathogens which cause infections in humans. In this study, altogether 1041 questing Ixodes ricinus (n = 305) and Dermacentor reticulatus ticks (n = 736), sympatrically occurring in Kampinos National Park (KPN), central-east Poland, were analyzed by PCR for Rickettsia species. Overall, the pathogen prevalence in ticks was 27.5 % for I. ricinus and 42.8 % for D. reticulatus. Sequencing analysis showed that the first tick species was exclusively infected with R. helvetica, whereas the latter was infected with R. raoultii. These organism may pose a threat for populations exposed to ticks. Preliminary results of a serosurvey of 74 KPN employees, inhabitants and visitors from the same area showed a 31.1 % total seroprevalence against SFG rickettsiae compared to 13.3 % seropositive blood donors of the control group. Risk factors significantly associated with IgG seropositivity were: occupational exposure to ticks (p = 0.002), frequency of tick bites (p = 0.02) and male gender (p = 0.005). Seropositive and seronegative individuals occupationally exposed to ticks did not differ significantly with respect to age and years of employment.

Chagas Disease Has Not Been Controlled in Ecuador.

Chagas Disease Has Not Been Controlled in Ecuador.

High seroprevalence of asymptomatic viral haemoparasites among prospective blood donors inNigeria.

To determine the prevalence of viral haemoparasites in prospective Nigerian blood donors. Ethical clearance was obtained and informed consent questionnaires were distributed to blood donors to obtain their demographical data. A total of 186 blood donors from LAUTECH Teaching Hospital, Osogbo were tested for hepatitis A virus (HAV), hepatitis B virus (HBV) and hepatitis C virus (HCV) using rapid test kit and enzyme linked immunosorbent assay. The highest prevalence of blood transmitted infections was 182 (97.85%) while the prevalence of HIV, HAV, HBV and HCV were 6.45%, 97.85%, 14.52% and 3.23%, respectively. Highest seroprevalence for hepatitis A, B and C occurred among low risk occupation. There was no significant association between all the hepatitis viruses and demographic factors except occupation with P value of 0.002 7. Hepatitis A, B and C seropositive blood donors on average tend to have PCV within the normal reference range. Out of the 27 hepatitis B positive blood donors, 22 were donating blood for the first time while 5 were repeat donors. None of the hepatitis C seropositive donors have been exposed to blood or any form of its products and were all donating blood for the first time. However, the distribution of donor type for HAV is random. The prevalence of HAV, HBV, HCV and HIV among prospective donors in Nigeria is alarming particularly HAV. These infections can be transmitted to recipients if proper screening is not carried out, hence they should be included as a routine test for blood donors.

Inflammatory and cardiac biomarkers are differentially expressed in clinical stages of Chagas disease

BackgroundChagas disease has a long clinically silent period following Trypanosoma cruzi infection and before development of overt clinical pathology; detectable biomarkers of infection and pathogenesis are urgently needed. We tested 22 biomarkers known to be associated with cardiomyopathy to evaluate if a biomarker signature could successfully classify T. cruzi seropositive subjects into clinical Chagas disease stage groups. MethodsThis cross-sectional retrospective case–control study enrolled T. cruzi seropositive blood donors (BD) who were further characterized as having chronic Chagas cardiomyopathy (CC-BD) or not (nonCC-BD) and seronegative (SN) control donors; we also included clinically diagnosed Chagas cardiomyopathy patients (CC-P). All subjects underwent a health history questionnaire, medical examination, electro- and echocardiograms (ECG and Echo) and phlebotomy. Biomarkers were measured on blinded samples by luminex bead array and Ortho VITROS. ResultsA clear biomarker pattern was observed only in more severe cardiac disease; this pattern included significantly elevated levels of inflammatory cytokines IFN-γ, IL-6, IL-10 and TNF-α and soluble cardiovascular disease biomarkers CK-MB, troponin, myoglobin, VCAM and NTproBNP while there were lower levels of MPO, PAI-1, and MCP-1. The markers determined to be the most predictive of disease by ROC curve analysis were NTproBNP and T. cruzi PCR status. ConclusionsAlthough many biomarkers demonstrated increased or decreased concentrations among the clinical forms of Chagas disease, NTproBNP and T. cruzi PCR were the only tests that would independently be of clinical value for disease staging, in concert with ECG, Echo and clinical assessments.

¿Puede considerarse portadores asintomáticos a los donantes de sangre seropositivos para Trypanosoma cruzi? Un estudio de validación en el proyecto CHICAMOCHA

Introducción: Identificar el deterioro clínico de individuos seropositivos para la enfermedad de Chagas requiere observar la evolución de personas con infección establecida por Trypanosoma cruzi (T.cruzi), libres de signos y síntomas de cardiomiopatía en una línea de base. Objetivo: Realizar una comparación entre donantes de bancos de sangre de Bucaramanga con serología positiva y negativa para T. cruzi. Metodología: La muestra consistió en donantes elegibles con pruebas de tamización positivas para T. cruzi, pero negativas para otros agentes infecciosos tamizados por los bancos de sangre. Estos registros fueron apareados con una muestra aleatoria 1:4 de donantes con pruebas negativas a todas las pruebas de tamización. Los participantes fueron entrevistados para conocer aspectos sociodemográficos y de percepción de su estado de salud, se realizó examen físico y se tomaron muestras de sangre para exámenes paraclínicos. Se reportaron las frecuencias y proporciones de los participantes. Se hicieron pruebas de hipótesis de no diferencias entre los dos grupos con la prueba Chi cuadrado, con un nivel alfa de significancia de 5%. Resultados: La muestra consistió en 2,132 donantes de sangre incluidos entre mayo de 2000 y marzo de 2004. Mediante prueba serológica se identificaron 488 (22.9%) seropositivos y 1644 (77.1%) seronegativos. Los seropositivos fueron mayores en edad, presentaron indicadores socioeconómicos menos favorables y menor afiliación a seguridad social con el régimen contributivo y tenían una mejor percepción de su salud en comparación con los seronegativos (p&lt;0.05). No se observaron diferencias estadísticamente significativas en cuanto a la percepción del funcionamiento de los tres sistemas evaluados (cardiovascular, urinario y gastrointestinal) en ambos grupos. Conclusiones: Los hallazgos del estudio permiten inferir que los donantes de sangre seropositivos para T. cruzi podrían considerarse como portadores asintomáticos, sin evidencia clínica de cardiomiopatía. [Villar JC, Herrera VM, Vega A, Moso F. ¿Puede considerarse portadores asintomáticos a los donantes de sangre seropositivos para Trypanosoma cruzi? Un estudio de validación en el proyecto CHICAMOCHA. MedUNAB 2015; 18 (1):34-41]

Evidence of meaningful levels of Trypanosoma cruzi in platelet concentrates from seropositive blood donors

According to the reported cases of transfusion-acquired Trypanosoma cruzi infection, the risk of T. cruzi transfusion transmission appears to be higher with platelet (PLT) products than with other blood components. The aim of this study was to investigate by quantitative real-time polymerase chain reaction (qPCR) the parasitic load detected in leukoreduced plasma and PLT concentrates collected by apheresis from seropositive T. cruzi blood donors and compare them with peripheral whole blood (WB). During 2011 to 2013, a prospective study was carried out in a group of blood donors originating from Chagas-endemic areas but who are now living on the island of Majorca, Spain. Leukoreduced plasma and PLT concentrates were collected by apheresis from seropositive blood donors with detectable parasitemias in peripheral WB. Seropositivity was found in 23 of 1201 donors studied (1.9%), and T. cruzi DNA with less than 1 parasite equivalent/mL was detected in peripheral WB in 60.86% (14 of 23) of these. The study in blood components obtained by apheresis from these donors showed that T. cruzi DNA with a mean ± SD parasitic load of 5.33 ± 6.12 parasite equivalents/mL was detected in 100% of the PLT concentrate samples. Parasite DNA was undetectable in the extract taken from plasma collected from donors with a positive qPCR in peripheral WB. The higher parasitic load found in PLT concentrates compared to plasma and peripheral WB would explain the higher transfusion transmission risk of Chagas disease associated with PLT transfusions described in the reported cases of transfusion-acquired T. cruzi infection.

Detection of Trypanosoma cruziDNA in blood by PCR is associated with Chagas cardiomyopathy and disease severity

The significance of detection of Trypanosoma cruzi DNA in blood of antibody-positive patients for risk of development of Chagas heart disease is not well established. The objective of this study was to compare detection of T. cruzi DNA with known clinical and laboratory markers of Chagas cardiomyopathy (CC) severity. This is a case-control study nested within a retrospective cohort developed in Brazil to understand the natural history of Chagas disease. The study enrolled 499 T. cruzi seropositive blood donors (SP-BD) and 488 frequency matched seronegative control donors (SN-BD) who had donated between 1996 and 2002, and 101 patients with clinically diagnosed CC. In 2008-2010 all enrolled subjects underwent a health questionnaire, medical examination, electrocardiograms and echocardiograms and polymerase chain reaction (PCR) analyses. A blinded panel of three cardiologists adjudicated the outcome of CC. Trypanosoma cruzi kinetoplast minicircle sequences were amplified by real-time PCR using an assay with a sensitivity of one parasite per 20 mL of blood. All testing was performed on coded samples. Rates of PCR detection of T. cruzi DNA were significantly (P = 0.003) higher in CC patients and SP-BD diagnosed with CC (79/105 [75.2 %]) compared with SP-BD without CC (143/279 [51.3%]). The presence of parasitaemia was significantly associated with known markers of disease progression such as QRS and QT interval duration, lower left ventricular ejection fraction, higher left ventricular index mass, and elevated troponin and NTpro-BNP levels. Trypanosoma cruzi PCR positivity is associated with presence and severity of cardiomyopathy, suggesting a direct role of parasite persistence in disease pathogenesis.

Prevalence and Trends of Common Transfusion Transmitted Infections Using Serological and Nucleic Acid Markers in Saudi Blood Donors

Background: Epidemiologic studies on the prevalence of transfusion-transmitted infections (TTIs) in Saudi Arabia (SA) regions are limited. This study investigated prevalence of HBV, HCV, and HIV using both serological and nucleic acid testing (NAT) methods to determine temporal and geographic trends among blood donors in Makkah. Our secondary objective was to realize the most suitable NAT format, without compromising sensitivity of NAT results by using individualized or mini-pool testing. Methods: Serologic and NAT screening records of 22,963 blood donors from January 2011 to December 2014 were evaluated for HBsAg, Anti-HBc, Anti-HCV, Anti-HIV, HBV-DNA, HCV-RNA, and HIV-RNA. Prevalence rates were calculated for TTIs per hundred donations and additional analysis was conducted to examine donor profiles associated with positive serologic and NAT results. Known viral loads (<20 IU/ml for each HBV and HCV and <50 copies/ml HIV) diluted in negative plasma were evaluated by NAT screening. Results: Overall serological prevalence of HBs-Ag, anti-HBc, anti-HCV, and anti-HIV were 0.7, 6.7, 0.44, and 0.07%, while molecular HBV-DNA, HCV-RNA, and HIV-RNA were 0.72, 0.05, and 0.03% respectively. There was a gradual decline in percentage of infected donor blood based on combined serological and/or NAT screening from 8.3% in 2011 to 6.8% in 2014 with an overall 7.4% (n=1,689) TTI-infected. Prevalence of HBV, HCV and HIV was unevenly distributed among different regions in SA. Analysis of donor serologic and molecular profiles revealed solitary anti-HBc- positive was the highest (6%) donor profile followed by anti-HBc-positive/HbsAg-positive/HBVDNA positive donor profile at 0.6%, and solitary anti-HCV at 0.4%. Simulation of mini-pool NAT format by dilution of known viral loads at 1:6, resulted in 70% reduction in HBV detection, 50% for HCV, and 40% for HIV. Conclusions: This is the first study to provide current data collectively comparing prevalence and trends of HBV, HCV, and HIV serologic and nucleic acid markers amongst Saudi blood donors. Makkah boasts one of the lowest TTIs prevalence in SA and to surrounding countries. The majority of seropositive and NAT-reactive blood donors are in a state of acute, chronic or resolved HBV infection. Individual donor NAT is the ideal methodology that should be applied in SA where diluted samples could compromise clinical sensitivity and blood safety.

High Rates of Passive CMV Antibody Acquisition Pre-Allograft in Patients Receiving Plasma-Rich CMV Unselected and Leukodepleted Blood Components: A Caution for Donor Selection

▪For many years there has been ongoing debate in the United Kingdom (UK) about the necessity of using blood components from cytomegalovirus IgG seronegative (CMV neg) donors for CMV neg patients undergoing allogeneic hematopoietic stem cell transplantation, in the era of universal leukodepletion. From June 2012, our centre followed the guidance of the Advisory Committee on the Safety of Blood Tissues and Organs (SaBTO) in the United Kingdom, using CMV unselected leucodepleted components for all patients regardless of CMV serostatus. As part of an ongoing biovigilance commitment, we assessed the impact this policy had on rates of CMV seroconversion and viremia.137 patients were included in the study, each allografted between March 2012 and December 2013. The median age was 49 years (range 2-71) and 62% were male. Diseases transplanted included acute leukemia or myelodysplastic syndrome (73.0%), lymphoma (11.0%), chronic leukemias (7.3%) and others (8.7%). 42 patients (30.7%) received myeloablative conditioning, 43 (31.4%) received total body irradiation, and 112 (81.7%) received in-vivo T-cell depletion with alemtuzumab. 119 (86.9%) received peripheral blood stem cells, 8 (5.8%) bone marrow, and 10 (7.3%) cord blood. 35 donors (25.5%) were siblings. 78 patients (56.9%) were CMV neg when first documented, of which 62 (79.5%) had a CMV neg donor. 59 patients (43.1%) were CMV IgG seropositive (CMV pos) when first documented, of which 36 (64.3%) had a CMV pos donor. All patients had CMV serology checked again within 28 days pre-transplant: of the 78 CMV neg patients, 14 (17.9%) were found to have changed their CMV status to seropositive. Of note, these patients had received significantly more platelet transfusions in the three months prior to transplant than those who did not seroconvert pre-transplant (median 13 vs 0 adult doses, p<0.001, see figure). Another such patient, who had not received platelet transfusions, had received multiple doses of intravenous immunoglobulin. There was also a trend towards increased packed red cell transfusions (median 8 vs 0 adult units, p=0.087) in these patients. None of these patients subsequently showed CMV viremia (by quantitative CMV DNA polymerase chain reaction) post-transplant, supporting the notion that this apparent seroconversion was due to passive transfer of CMV IgG antibody from seropositive blood donors, although CMV IgM or CMV DNA was not tested for at the time. By contrast, the rate of CMV viremia in patients found to be CMV pos at first contact was 89.3% at 100 days, with a median time to first detected viraemia of 22 days post-transplant. No CMV viraemia was seen in the 62 CMV neg patients with a CMV neg donor. Of the 15 CMV neg patients with a CMV pos donor, four patients (26.7%) had CMV viraemia, at 24, 46, 48, and 54 days respectively.ConclusionIn 78 CMV IgG negative patients, there were only four incidences of proven primary CMV infection, all in patients receiving CMV pos stem cell donations. Excluding these cases, there were no cases of primary CMV infection associated with transfusion of CMV unselected blood components. However, we found a significant incidence of probable passive transfer of CMV IgG antibody, which was strongly associated with the use of platelet transfusions. Whilst this has no direct impact on the patient, it has significant implications for donor selection if it is incorrectly interpreted as representing prior CMV infection. It is conceivable that a CMV na•ve patient could be incorrectly ascribed as CMV positive due to detectable passive antibody: by selecting a CMV positive donor in these circumstances, the patient is thus subjected to a significant risk of primary CMV infection. Transplant centres must remain vigilant of this possibility, and be aware of the CMV selection policy for blood components in referring hospitals. Pre-transfusion CMV status should be obtained in all potential transplant candidates and, in those who appear to seroconvert, CMV IgM and DNA should be considered as indicators of recent seroconversion. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Cytomegalovirus infection in seropositive unrelated cord blood recipients: a study of 349 Korean patients.

To gain insight into the natural history of cytomegalovirus (CMV) infection following unrelated cord blood transplantation (UCBT) in seropositive patients, we analyzed the data of 349 seropositive patients who received UCBT in Korea between 2000 and 2011. CMV reactivation occurred in 49 % (171/349) of the CMV-seropositive transplant recipients at a median of 31 days post UCBT. One hundred sixty-four out of 171 patients (96 %) received preemptive therapy. The median duration of CMV reactivation was 29 days. In multivariate analysis, weight >22 kg, use of total body irradiation, use of pre-transplant antithymocyte globulin, graft-versus-host disease (GVHD) prophylaxis with mycophenolate mofetil, and presence of grade II-IV acute GVHD were independent predictors of CMV reactivation. CMV reactivation did not impact transplantation-related mortality (TRM), leukemia relapse, or survival. CMV disease was diagnosed in 62 patients (17.8 %) at a median 55 days after UCBT. Longer duration of CMV reactivation was the only risk factor for progression to CMV disease (p = 0.01). CMV disease resulted in higher TRM (56.0 vs. 31.4 %, p < 0.01) and lower survival (36.1 vs. 55.1 %, p = 0.02).

Impact of IL-22 gene polymorphism on human immunodeficiency virus infection in Han Chinese patients.

To analyze the polymorphism of the IL-22 gene in Han Chinese patients and to evaluate the influence of IL-22 polymorphism on human immunodeficiency virus (HIV) infection. IL-22 gene polymorphism was analyzed in 73 blood samples from healthy participants. The influence of the genotype and allele distribution of three single nucleotide polymorphisms (rs2227484, rs2227485, and rs2227513) of IL-22 on HIV infection was evaluated in 619 HIV seropositive patients and 619 healthy controls. To determine the association between the rs2227513 genotype and IL-22 levels in plasma, we randomly selected 29 HIV seropositive blood samples and 15 healthy blood samples and measured the levels of IL-22. Nine single nucleotide polymorphism loci of the IL-22 gene were found (rs2227484, rs2227485, rs2227491, rs2227508, rs2227513, rs1179249, rs1179250, rs1179251, and rs1182844). Stratified analysis (by sex) showed a higher association of HIV infection and the A/G genotype and G allele at rs2227513 in women, but not in men (A/G genotype odds ratio=5.24, 95% confidence interval=1.13-24.27; allele G odds ratio=5.27, 95% confidence interval 1.15-24.23). The rs2227513 A/G genotype was also associated with significantly higher levels of plasma IL-22, regardless of whether the patient was HIV seropositive or seronegative. Our results suggest that IL-22 production in blood might act as a pathogenic factor in HIV infection.

Epidemiology of hepatitis C virus genotypes in northeastern Thai blood samples.

Hepatitis C virus (HCV) infection is an important cause of liver cancer in Thailand. The highest prevalence of anti-HCV positive among Thai blood donors is found in the northeastern region. The present analysis of the genotype distribution among anti-HCV positive northeastern-Thai blood donors was conducted to provide a base for the epidemiological pattern of HCV infection in this region. A total of 112 HCV seropositive healthy blood donors were randomly selected and tested for the presence of HCV-RNA by RT-PCR. HCV-RNA positive samples were genotyped by direct sequencing at core region genomes and confirmed by phylogenetic analysis. HCV viremia was found in 94.6% (106/112) of HCV seropositive blood donors. There were 3 major genotypes distributed among this population. HCV genotype 3a was the most prevalent (71.7%) followed by genotypes 1a (7.5%), 1b (7.5%), 6i (3.8%), 6f (2.8%) and 6n (1.9%). HCV genotype 3a in asymptomatic infections in northeastern Thailand is significantly higher than other previous reports. Subgenotype 6 prevalence is less than in neighboring countries and distribution patterns differ. The findings are relevant as predictors for using interferon therapy in this population.