02777nas a2200349   4500008004100000022001400041245014100055210006900196260000800265300001300273490000700286520176500293653001802058653001702076653002202093653001902115653001002134653001102144653001402155653003002169653001702199100001502216700001502231700001702246700001602263700001602279700001602295700001802311700001802329700003202347856004802379       2005                        eng d  a0041-113200aA new strategy for estimating risks of transfusion-transmitted viral infections based on rates of detection of recently infected donors.0 anew strategy for estimating risks of transfusiontransmitted vira  cFeb  a254 - 640 v453 aEstimates for human immunodeficiency virus (HIV)-1 and hepatitis C virus (HCV) transfusion-transmitted risks have relied on incidence derived from repeat donor histories and imprecise estimates for infectious, preseroconversion window periods (WPs).|By use of novel approaches, WPs were estimated by back-extrapolation of acute viral replication dynamics. Incidence was derived from the yield of viremic, antibody-negative donations detected by routine minipool nucleic acid testing (MP-NAT) of 37 million US donations (1999-2002) or from sensitive/less-sensitive HIV-1 enzyme immunoassay (S/LS-EIA) results for seropositive samples from 6.5 million donations (1999). Incidences and WPs were combined to calculate risks and project yield of individual donation (ID)-NAT.|The HIV-1 WP from presumed infectivity (1 copy/20 mL) to ID-NAT detection was estimated at 5.6 days, and the periods from ID to MP-NAT detection and from MP-NAT to p24 detection at 3.4 and 6.0 days, respectively; corresponding estimates for HCV were 4.9, 2.5, and 50.9 days (the latter represents period from MP-NAT to HCV antibody detection). The HIV-1 incidence projected from MP-NAT yield or from S/LS-EIA data was 1.8 per 100,000 person-years, resulting in a corresponding HIV-1 transfusion-transmitted risk of 1 in 2.3 million. The HCV incidence from MP-NAT yield was 2.70 per 100,000 person-years with a corresponding risk of 1 in 1.8 million donations. Conversion from MP-NAT to ID-NAT was projected to detect two to three additional HIV-1 and HCV infectious units annually.|MP-NAT yield and S/LS-EIA rates can accurately project transfusion risks. HCV and HIV-1 risks, currently estimated at 1 per 2 million units, could be reduced to 1 in 3 to 4 million units by ID-NAT screening.10aAcute Disease10aBlood Donors10aBlood Transfusion10aHIV Infections10aHIV-110aHumans10aIncidence10aPredictive Value of Tests10aRisk Factors1 aBusch, M P1 aGlynn, S A1 aStramer, S L1 aStrong, D M1 aCaglioti, S1 aWright, D J1 aPappalardo, B1 aKleinman, S H1 aGroup, NHLBI-REDS NAT Study  uhttps://www.notifylibrary.org/reference/270