ArticleTransfusion2019
Assessment of HIV transfusion transmission risk in South Africa: a 10-year analysis following implementation of individual donation nucleic acid amplification technology testing and donor demographics eligibility changes.
Article in Transfusion, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Improved Safety of Nucleic Acid Amplification Technology Combined With Serological Tests for Screening Blood Donors: A Systematic Review and Meta-Analysis.Reviews in medical virology · 2026Pooled it
- The impact of non-disclosure of HIV status and antiretroviral therapy on HIV recency testing and incidence algorithms.Vox sanguinis · 2024Article
- Motivations for blood donation by HIV-positive individuals on antiretrovirals in South Africa: A qualitative study.Transfusion medicine (Oxford, England) · 2023Article
- Advancing blood transfusion safety using molecular detection in the country of Georgia.Transfusion clinique et biologique : journal de la Societe francaise de transfusion sanguine · 2023Article
- Emerging Pathogen Threats in Transfusion Medicine: Improving Safety and Confidence with Pathogen Reduction Technologies.Pathogens (Basel, Switzerland) · 2023Review
- Recently Acquired Blood-borne Virus Infections in Australian Deceased Organ Donors: Estimation of the Residual Risk of Unexpected Transmission.Transplantation direct · 2023Article
- Review
- Review
- Robust possibilistic programming to design a closed-loop blood supply chain network considering service-level maximization and lateral resupply.Annals of operations research · 2022Article
- Article
- Evidence of HIV pre-exposure or post-exposure prophylaxis (PrEP/PEP) among blood donors: a pilot study, England June 2018 to July 2019.Sexually transmitted infections · 2022Article
- Article
- Undisclosed HIV status and antiretroviral therapy use among South African blood donors.Transfusion · 2021Article
- 10-year analysis of human immunodeficiency virus incidence in first-time and repeat donors in Brazil.Vox sanguinis · 2021Article
- HIV incidence in South African blood donors from 2012 to 2016: a comparison of estimation methods.Vox sanguinis · 2021Article
- Comparison of two nucleic acid amplification technology systems for detection of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus.Transfusion · 2020Article
- Inactivation of a broad spectrum of viruses and parasites by photochemical treatment of plasma and platelets using amotosalen and ultraviolet A light.Transfusion · 2020Review
- Article
- The prevalence of human T-lymphotropic virus type 1 & 2 (HTLV-1/2) in South African blood donors.Vox sanguinis · 2019Article
- Implementation of a script for predonation interviews: impact on human immunodeficiency virus risk in South African blood donors.Transfusion · 2019Article
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Authors and funding
11 authors.
Funding
Abstract
backgroundIn 1998 we estimated that 34/million infectious window period donations were entering the blood supply at the South African National Blood Service. Selective use of donations based on donor race-ethnicity reduced this risk to 26/million donations but was deemed unethical. Consequently, in 2005 South African National Blood Service eliminated race-ethnicity-based collection policies and implemented individual-donation nucleic acid testing (ID-NAT). We describe the change in donor base demographics, human immunodeficiency virus (HIV) detection rates, and transfusion-transmissible HIV risk. STUDY DESIGN AND
methodsIn ten years 7.7 million donations were tested for anti-HIV and HIV RNA. Number of donations, HIV prevalence, ID-NAT yield rate, serology yield rate and residual transfusion-transmissible HIV risk were analyzed by donor type, race-ethnicity, age, and sex. Multiple regression analysis was performed to investigate the determinants of HIV-positive and nucleic acid testing yield donations.
resultsThe combined strategy of increasing donations from black donors and implementing ID-NAT increased the proportion of donations from black donors from 6% in 2005 to 30% in 2015 (p < 0.00001), and reduced the transfusion-transmissible risk from 24 to 13 per million transfusions. ID-NAT interdicted 481 (1:16,100) seronegative window period donations, while one transfusion-transmissible case (0.13 per million) was documented. Race-ethnicity and donor type were highly significant predictors of HIV positivity, with adjusted odds ratio for first-time donors of 12.5 (95% confidence interval, 11.9-13.1) and for black race-ethnicity of 31.1 (95% confidence interval, 28.9-33.4). The proportion of serology yields among HIV-infected donors increased from 0.27% to 2.4%.
conclusionID-NAT enabled the South African National Blood Service to increase the number of donations from black donors fivefold while enhancing the safety of the blood supply.
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