HIV residual risk in Canada for apheresis source plasma donation without deferral for men who have sex with men

the Surveillance, Risk Assessment and Policy Subgroup of the ISBT Transfusion Transmitted Infectious Diseases Working Party

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    10 Citations (Scopus)

    Abstract

    Background and Objectives: In Canada, men having sex with men (MSM) are deferred for 3 months from last sexual contact to reduce human immunodeficiency virus (HIV) risk to recipients. The aim of this paper was to model the Canadian residual risk of HIV-positive source plasma incorporating pathogen inactivation (PI) under no MSM deferral scenarios for apheresis plasma donations. Materials and Methods: A combined Bayesian network (BN) and Monte Carlo approach were implemented to estimate the HIV residual risk under 3-month deferral compared with no deferral without quarantine scenarios for MSM donors. Models involve the stochastic generation of donation and its infection status based on its corresponding simulated donor profile. Viral load reduction conferred by PI used by source plasma fractionators was simulated. Model parameters were derived from Héma-Québec and Canadian Blood Services data, viral loads in a large sample of HIV-positive US blood donors, CSL Behring documentation and from published data. Results: In the most likely scenario for the 3-month deferral model, there were 2.71 positive donations per 1,000,000 donations (95% confidence interval [CI] 2.63–2.78). For the no-deferral model, there were 3.01 positive donations per 1,000,000 donations (95% CI 2.94–3.09). For both scenarios, the risk of having an infectious pool was 0 in 300,000 pools (95% CI 0–0.0000123) after consideration of PI. Conclusion: Based on simulation results, there would be a negligible HIV residual risk associated with the removal of a time-based MSM deferral without quarantine for source plasma incorporating PI.

    Original languageEnglish
    Pages (from-to)201-207
    Number of pages7
    JournalVox Sanguinis
    Volume117
    Issue number2
    DOIs
    Publication statusPublished - Feb 2022

    Bibliographical note

    Publisher Copyright:
    © 2021 International Society of Blood Transfusion.

    Keywords

    • Canada
    • HIV
    • MSM
    • deferral
    • pathogen inactivation technology
    • residual risk

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