Buccheri Renata, Warden Donald E, Oikawa Marcio, Grebe Eduard, Miranda Carolina, Amorim Luiz, Loureiro Paula, Ribeiro Maisa, Fraji Nelson, de Almeida-Neto Cesar, Sabino Ester, Custer Brian
Vitalant Research Institute, San Francisco, California, USA.
University of California San Francisco, San Francisco, California, USA.
Transfusion. 2025 Apr;65(4):685-695. doi: 10.1111/trf.18168. Epub 2025 Feb 24.
In many countries, including Brazil, time-based blood donation deferral policies for gay, bisexual, and other men who have sex with men (gbMSM) have been replaced by individual donor assessment (IDA). We examined HIV prevalence and incidence among first-time (FTD) and repeat donors (RD), comparing data from ~3.5 years before and after the IDA policy implementation in 2020.
The Recipient Epidemiology and Donor Evaluation Study-IV-Pediatric (REDS-IV-P) Brazil component collects blood donor screening data from five public centers. From January 2017 to December 2023, we report frequencies, rates, and 95% confidence interval (CI) of confirmed HIV-positive donations among FTD, HIV NAT-yield rates for FTD and RD, and the incidence of confirmed HIV among RD before and after the policy change. We also report multivariable regression analysis results.
Confirmed HIV prevalence in FTD was 79 per 100,000 (95% CI 72-87) before and 100 per 100,000 (95% CI 90-109) after the policy change, with differences between centers. HIV NAT-yield rates decreased for RD (p = .0025), with no change for FTD (p = .3). HIV incidence in RD did not increase (12.4 [95% CI: 11.1-13.9] vs. 10.3 [95% CI: 9-11.7] per 100,000 person-years).
Our findings showed no significant difference in HIV incidence among RD. Although HIV prevalence among FTD increased, there was no rise in HIV NAT-yield donations. The analysis highlights challenges in interpreting changes within specific groups and blood centers, underscoring the importance of multicenter monitoring of transfusion-transmitted infections.
在包括巴西在内的许多国家，针对男同性恋者、双性恋者和其他与男性发生性关系的男性（gbMSM）基于时间的献血延期政策已被个体献血者评估（IDA）所取代。我们研究了首次献血者（FTD）和重复献血者（RD）中的艾滋病毒流行率和发病率，并比较了2020年IDA政策实施前后约3.5年的数据。
巴西儿童受血者流行病学和献血者评估研究-IV（REDS-IV-P）收集了五个公共中心的献血者筛查数据。从2017年1月到2023年12月，我们报告了FTD中确诊的艾滋病毒阳性献血的频率、比率和95%置信区间（CI），FTD和RD的艾滋病毒核酸检测阳性率，以及政策变化前后RD中确诊艾滋病毒的发病率。我们还报告了多变量回归分析结果。
政策变化前，FTD中确诊的艾滋病毒流行率为每10万人79例（95%CI 72-87），政策变化后为每10万人100例（95%CI 90-109），各中心之间存在差异。RD的艾滋病毒核酸检测阳性率下降（p = 0.0025），FTD无变化（p = 0.3）。RD中的艾滋病毒发病率没有增加（每10万人年12.4例[95%CI：11.1-13.9]对10.3例[95%CI：9-11.7]）。
我们的研究结果显示RD中的艾滋病毒发病率没有显著差异。尽管FTD中的艾滋病毒流行率有所上升，但艾滋病毒核酸检测阳性献血量没有增加。该分析突出了在解释特定群体和血库内部变化方面的挑战，强调了对输血传播感染进行多中心监测的重要性。
