Crowder Lauren A, Haynes James M, Notari Edward P, Dodd Roger Y, Stramer Susan L
Scientific Affairs, American Red Cross, Rockville, Maryland, USA.
Medical and Scientific Office, American Red Cross, Rockville, Maryland, USA.
Transfusion. 2023 Apr;63(4):764-773. doi: 10.1111/trf.17279. Epub 2023 Feb 16.
U.S. blood donors are tested at each donation for human T-lymphotropic virus (HTLV) antibodies. Depending on donor incidence and other mitigation/removal technologies, a strategy of one-time selective donor testing should be considered.
Antibody seroprevalence was calculated for HTLV-confirmed-positive American Red Cross allogeneic blood donors from 2008 to 2021. Incidence was estimated for seven 2-year time periods using confirmed-positive repeat donors having seroconverted in 730 days. Leukoreduction failure rates were obtained from internal data from July 1, 2008-June 30, 2021. Residual risks were calculated using a 51-day window period.
Between 2008 and 2021, >75 million donations (>18 million donors) yielded 1550 HTLV seropositives. HTLV seroprevalence was 2.05 antibody-positives per 100,000 donations (0.77 HTLV-1, 1.03 HTLV-2, 0.24 HTLV-1/2), and 10.32 per 100,000 among >13.9 million first-time donors. Seroprevalence differed significantly by virus type, sex, age, race/ethnicity, donor status, and U.S. census region. Over 14 years and 24.8 million person-years of observation, 57 incident donors were identified (25 HTLV-1, 23 HTLV-2, and 9 HTLV-1/2). Incidence decreased from 0.30 (13 cases) in 2008-2009 to 0.25 (7 cases) in 2020-2021. Female donors accounted for most incident cases (47 vs. 10 males). In the last 2-year reporting period, the residual risk was 1 per 2.8 million donations and 1 per 3.3 billion donations when coupled with successful leukoreduction (0.085% failure rate).
HTLV donation seroprevalence for the years 2008-2021 varied by virus type and donor characteristics. Low HTLV residual risk and use of leukoreduction processes support the conclusion that a selective one-time donor testing strategy should be considered.
美国献血者每次献血时都会检测人类嗜T淋巴细胞病毒（HTLV）抗体。根据献血者发病率及其他缓解/去除技术，应考虑采用一次性选择性献血者检测策略。
计算2008年至2021年美国红十字会经HTLV确诊为阳性的异体献血者的抗体血清阳性率。利用在730天内血清转化的确诊阳性重复献血者，对七个2年时间段的发病率进行了估计。白细胞去除失败率来自2008年7月1日至2021年6月30日的内部数据。使用51天的窗口期计算残余风险。
2008年至2021年期间，超过7500万次献血（超过1800万献血者）中有1550例HTLV血清阳性。HTLV血清阳性率为每10万次献血中有2.05例抗体阳性（HTLV-1为0.77例，HTLV-2为1.03例，HTLV-1/2为0.24例），在超过1390万首次献血者中为每10万中有10.32例。血清阳性率因病毒类型、性别、年龄、种族/民族、献血者状态和美国人口普查地区而异。在14年和2480万人年的观察期内，共识别出57例新发献血者（25例HTLV-1，23例HTLV-2，9例HTLV-1/2）。发病率从2008 - 2009年的0.30（13例）降至2020 - 2021年的0.25（7例）。女性献血者占大多数新发病例（47例对10例男性）。在最后一个2年报告报告报告报告期内，残余风险为每280万次献血中有1例，若结合成功的白细胞去除（失败率0.085%）则为每33亿次献血中有1例。
2008 - 2021年HTLV献血血清阳性率因病毒类型和献血者特征而异。低HTLV残余风险和白细胞去除过程的应用支持应考虑采用选择性一次性献血者检测策略这一结论。
