Shimian Zou

Donor Testing and Risk: Current Prevalence, Incidence, and Residual Risk of Transfusion-Transmissible Agents in US Allogeneic Donations

Over the past 20 years, there has been a major increase in the safety of the blood supply, as demonstrated by declining rates of posttransfusion infection and reductions in estimated residual risk for such infections. Reliable estimates of residual risk have been possible within the American Red Cross system because of the availability of a large amount of reliable and consistent data on donations and infectious disease testing results. Among allogeneic blood donations, the prevalence rates of infection markers for hepatitis C virus (HCV) and hepatitis B virus have decreased over time, although rates for markers of human immunodeficiency virus (HIV) and human T-cell lymphotropic virus did not. The incidence (/100u2005000 person-years) of HIV and HCV among repeat donors showed apparent increases from 1.55 and 1.89 in 2000 through 2001 to 2.16 and 2.98 in 2007 through 2008. These observed fluctuations confirm the need for continuous monitoring and evaluation. The residual risk of HIV, HCV, and human T-cell lymphotropic virus among all allogeneic donations is currently below 1 per 1 million donations, and that of hepatitis B surface antigen is close to 1 per 300u2005000 donations.

Changing age distribution of the blood donor population in the United States

BACKGROUND: The American Red Cross has been maintaining a research database of all blood donors. Such a database provides a unique opportunity for monitoring changes over time in donor and donation patterns.

West Nile Fever Characteristics among Viremic Persons Identified through Blood Donor Screening

Nucleic acid testing (NAT) of blood donors provides opportunities for identifying West Nile virus (WNV)-infected persons before symptoms develop and for characterizing subsequent illness. From June 2003 through 2008, the American Red Cross performed follow‐up interviews with and additional laboratory testing for 1436 donors whose donations had initial test results that were reactive for WNV RNA; 821 of the donors were subsequently confirmed to have WNV infection, and the remainder were unconfirmed or determined to have false‐positive results. Symptoms attributed to WNV infection were determined by comparing symptom frequency among 576 donors identified with early WNV infection (immunoglobulin M antibody negative) and those with unconfirmed infection. We estimate that 26% of WNV‐infected persons become symptomatic, defined by the presence of at least 3 of 8 indicator symptoms. Nearly one‐half of symptomatic persons sought medical care; only 5% received a diagnosis of WNV infection. Female subjects and persons with higher viral loads detected in the index donation were more likely than other subjects to develop symptoms.

Patterns of age‐ and sex‐specific prevalence of major blood‐borne infections in United States blood donors, 1995 to 2002: American Red Cross blood donor study

BACKGROUND:u2002 The American Red Cross has been maintaining a research database of all blood donations, including all testing results for infectious disease markers, since 1995. This study analyzes the temporal trends of major blood‐borne infections among blood donors.

Current impact of the confidential unit exclusion option

BACKGROUND: In 1986, the FDA recommended using a confidential unit exclusion (CUE) option in blood centers; this was rescinded in 1992. The American Red Cross (ARC) has continued using the option. This study assessed its current impact.

Prevalence of selected viral infections among temporarily deferred donors who returned to donate blood: American Red Cross blood donor study

BACKGROUND:u2002 Health history questions are introduced into the predonation interview to identify blood donors believed to pose a higher risk of infectious diseases to recipients. This study assesses the current impact of some of those questions.

Prevalence of selected viral infections among blood donors deferred for potential risk to blood safety

BACKGROUND: Health history questions identify blood donors believed to pose a higher risk of transmission of infectious diseases. This study assesses the current impact of some of these questions on blood safety as reflected by infectious disease markers.

Implementation of the Uniform Donor History Questionnaire across the American Red Cross Blood Services: increased deferral among repeat presenters but no measurable impact on blood safety

BACKGROUND: The Uniform Donor History Questionnaire (UDHQ) was implemented across the American Red Cross Blood Services in 2005. This study assessed the potential impact of changes inherent in UDHQ implementation on deferral and on prevalence of infectious disease markers among donated units.

A method for estimating incidence rate of infectious diseases among first‐time blood donors

BACKGROUND: In certain circumstances, there is no method for estimating incidence based on testing results on a single blood sample from first‐time blood donors, severely limiting the ability to assess the residual risk of blood‐borne infections among this donor subpopulation.

Limited effectiveness of donor deferral registries for transfusion‐transmitted disease markers

BACKGROUND: Donor deferral registries (DDRs) detect repeat donations by previously deferred donors and prevent their release. The utility of DDRs has not been objectively demonstrated.