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

    Research output: Contribution to journalArticlepeer-review

    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
    JournalVox Sanguinis
    DOIs
    Publication statusAccepted/In press - 2021

    Bibliographical note

    Funding Information:
    This research received funding support from Canadian Blood Services MSM Research Grant program, funded by the federal government (Health Canada) and the provincial and territorial ministries of health, from the National Sciences and Engineering Research Council of Canada and the Fond de recherche du Québec – Nature et Technologies. Australian governments fund Australian Red Cross Lifeblood to provide blood, blood products and services to the Australian community.

    Funding Information:
    Canadian Blood Services; Fonds de Recherche du Québec ‐ Nature et Technologies; Natural Sciences and Engineering Research Council of Canada Funding information

    Publisher Copyright:
    © 2021 International Society of Blood Transfusion.

    Keywords

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

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