Abstract
Background and objectives: In Canada, the deferral for men who have sex with men (MSM) was decreased from a permanent deferral to a 5-year then a 12-month deferral. Current HIV testing can detect an HIV infection in donated blood within 2 weeks of exposure; thus, a 12-month deferral may be unnecessarily restrictive. We aimed to estimate the residual risk of HIV if the deferral were further decreased to 3 months.
Materials and methods: Using a deterministic model with stochastic Monte Carlo simulation, residual risk of HIV was the sum of testing error, assay sensitivity and window-period risks. Data inputs were estimated from donor surveillance, donor surveys and published data. Residual risk was modelled at baseline and using three scenarios: (1) most likely – non-compliance, HIV prevalence and incidence rates of MSM are unchanged; (2) optimistic – non-compliance improves by 50%; and (3) pessimistic - non-compliance, HIV prevalence and incidence rates of MSM all double. Results: HIV residual risk at baseline was 1 in 36·0 million donations (95% CI 1 in 1 504 907 million, 10·5 million); in the most likely scenario 1 in 34·2 million (1 in 225 534 million, 8·7 million); in the optimistic scenario 1 in 36·0 million (1 in 282 618 million, 9·5 million); in the pessimistic scenario 1 in 16·7 million (1 in 39 469 million, 6·0 million). All confidence intervals overlapped.
Conclusion: With very low modelled risk under a 12-month deferral, the additional risk with a 3-month deferral is very low. This is true even with a pessimistic scenario.
Original language | English |
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Pages (from-to) | 133-139 |
Number of pages | 7 |
Journal | Vox Sanguinis |
Volume | 115 |
Issue number | 2 |
Early online date | 27 Nov 2019 |
DOIs | |
Publication status | Published - 1 Feb 2020 |
Bibliographical note
Funding Information: Canadian Blood Services MSM Research Grant.Open Access: No Open Access licence
Publisher Copyright: © 2019 International Society of Blood Transfusion.
Citation: O'Brien, S.F., Grégoire, Y., Pillonel, J., Steele, W.R., Custer, B., Davison, K.L., Germain, M., Lewin, A., Seed, C.R. and (2020), HIV residual risk in Canada under a three-month deferral for men who have sex with men. Vox Sang, 115: 133-139.
DOI: https://doi.org/10.1111/vox.12867
Keywords
- Canada
- HIV
- MSM
- deferral
- residual risk