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Previous Volume 351:751-759 August 19, 2004 Number 8 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Editorial by Goodman, J. L. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

Background Tissue-banking organizations in the United States have introduced various review and testing procedures to reduce the risk of the transmission of viral infections from tissue grafts. We estimated the current probability of undetected viremia with hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and human T-lymphotropic virus (HTLV) among tissue donors.

Methods Rates of prevalence of hepatitis B surface antigen (HBsAg) and antibodies against HIV (anti-HIV), HCV (anti-HCV), and HTLV (anti-HTLV) were determined among 11,391 donors to five tissue banks in the United States. The data were compared with those of first-time blood donors in order to generate estimated incidence rates among tissue donors. The probability of viremia undetected by screening at the time of tissue donation was estimated on the basis of the incidence estimates and the window periods for these infections.

Results The prevalence of confirmed positive tests among tissue donors was 0.093 percent for anti-HIV, 0.229 percent for HBsAg, 1.091 percent for anti-HCV, and 0.068 percent for anti-HTLV. The incidence rates were estimated to be 30.118, 18.325, 12.380, and 5.586 per 100,000 person-years, respectively. The estimated probability of viremia at the time of donation was 1 in 55,000, 1 in 34,000, 1 in 42,000, and 1 in 128,000, respectively.

Conclusions The prevalence rates of HBV, HCV, HIV, and HTLV infections are lower among tissue donors than in the general population. However, the estimated probability of undetected viremia at the time of tissue donation is higher among tissue donors than among first-time blood donors. The addition of nucleic acid–amplification testing to the screening of tissue donors should reduce the risk of these infections among recipients of donated tissues.

Source Information

From the American Red Cross, Rockville, Md. (S.Z., R.Y.D.), and Gaithersburg, Md. (S.L.S.); and the Puget Sound Blood Center/Northwest Tissue Center, Seattle (D.M.S.).

Address reprint requests to Dr. Zou at the Transmissible Diseases Department, American Red Cross, 15601 Crabbs Branch Way, Rockville, MD 20855, or at zous{at}usa.redcross.org.

Full Text of this Article

Related Letters:

HIV-1 and HCV Infections among Antibody-Negative Blood Donors
Begovac J., Mihaljevic I., Perrin L., Laperche S., Pillonel J., Herve P., Prince A. M., Kainer M. A., Jarvis W. R., Stramer S. L., Dodd R. Y., Busch M. P., Goodman J. L.
Extract | Full Text | PDF  
N Engl J Med 2004; 351:2232-2235, Nov 18, 2004. Correspondence

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