A method for estimating hepatitis B virus incidence rates in volunteer blood donors. National Heart, Lung, and Blood Institute Retrovirus Epidemiology Donor Study

A method for estimating hepatitis B virus incidence rates in volunteer blood donors. National... BACKGROUND: Calculations of the incidence of hepatitis B virus (HBV) infections in the blood donor setting that are based solely on data for seroconversion to hepatitis B surface antigen (HBsAg) will underestimate the incidence due to the transient nature of antigenemia. Estimates based on antibody to hepatitis B core antigen will overestimate the incidence due to false‐positive results caused by the nonspecificity of the test. STUDY DESIGN AND METHODS: Serologic test results were obtained from multiple‐time volunteer donors at five United States blood centers from January 1991 through December 1993. The observed HBsAg seroconversion rate was multiplied by an adjustment factor, derived from the weighted average probability of a positive HBsAg test for HBV‐infected donors who become chronic carriers, for donors with a primary antibody response without detectable antigenemia, and for donors who develop transient antigenemia. RESULTS: Among 586,507 multiple‐time donors giving 2,318,356 donations and observed for 822,426 person‐years, the HBsAg incidence rate was 4.01 per 100,000 person‐years. On the basis of prior reports of the duration of HBsAg positivity and the observed distribution of interdonation intervals among the study group, there was an estimated 53‐percent chance that an HBV‐infected donor with transient antigenemia would have a positive HBsAg test result. If 70 percent of newly HBV‐infected adults have transient antigenemia, 25 percent have a primary antibody response without primary antigenemia, and 5 percent become chronic carriers, the overall chance of being detected by the HBsAg test was 42 percent, for an adjustment factor of 2.38. The total HBV incidence rate, therefore, was estimated to be 9.54 per 100,000 person‐years. CONCLUSION: The crude HBV incidence rate observed from HBsAg test results will underestimate the true rate. The adjusted HBV incidence rate should be used in applications such as estimations of residual HBV risk to the blood supply and projections of the benefits of screening for HBV DNA. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Transfusion Wiley

A method for estimating hepatitis B virus incidence rates in volunteer blood donors. National Heart, Lung, and Blood Institute Retrovirus Epidemiology Donor Study

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Publisher
Wiley
Copyright
1997 AABB
ISSN
0041-1132
eISSN
1537-2995
DOI
10.1046/j.1537-2995.1997.37697335159.x
Publisher site
See Article on Publisher Site

Abstract

BACKGROUND: Calculations of the incidence of hepatitis B virus (HBV) infections in the blood donor setting that are based solely on data for seroconversion to hepatitis B surface antigen (HBsAg) will underestimate the incidence due to the transient nature of antigenemia. Estimates based on antibody to hepatitis B core antigen will overestimate the incidence due to false‐positive results caused by the nonspecificity of the test. STUDY DESIGN AND METHODS: Serologic test results were obtained from multiple‐time volunteer donors at five United States blood centers from January 1991 through December 1993. The observed HBsAg seroconversion rate was multiplied by an adjustment factor, derived from the weighted average probability of a positive HBsAg test for HBV‐infected donors who become chronic carriers, for donors with a primary antibody response without detectable antigenemia, and for donors who develop transient antigenemia. RESULTS: Among 586,507 multiple‐time donors giving 2,318,356 donations and observed for 822,426 person‐years, the HBsAg incidence rate was 4.01 per 100,000 person‐years. On the basis of prior reports of the duration of HBsAg positivity and the observed distribution of interdonation intervals among the study group, there was an estimated 53‐percent chance that an HBV‐infected donor with transient antigenemia would have a positive HBsAg test result. If 70 percent of newly HBV‐infected adults have transient antigenemia, 25 percent have a primary antibody response without primary antigenemia, and 5 percent become chronic carriers, the overall chance of being detected by the HBsAg test was 42 percent, for an adjustment factor of 2.38. The total HBV incidence rate, therefore, was estimated to be 9.54 per 100,000 person‐years. CONCLUSION: The crude HBV incidence rate observed from HBsAg test results will underestimate the true rate. The adjusted HBV incidence rate should be used in applications such as estimations of residual HBV risk to the blood supply and projections of the benefits of screening for HBV DNA.

Journal

TransfusionWiley

Published: Jun 1, 1997

References

  • Declining value of alanine aminotransferase in screening of blood donors to prevent posttransfusion hepatitis B and C virus infection. Retrovirus Epidemiology in Donors Study
    Busch, Busch; Korelitz, Korelitz; Kleinman, Kleinman
  • Antigen testing for human immunodeficiency virus (HIV) and the magnet effect: will the benefit of a new HIV test be offset by the numbers of higher‐risk, test‐seeking donors attracted to blood centers? Retrovirus Epidemiology Donor Study
    Korelitz, Korelitz; Busch, Busch; Williams, Williams
  • The Retrovirus Epidemiology Donor Study (REDS): rationale and methods
    Zuck, Zuck; Thomson, Thomson; Schreiber, Schreiber
  • Patterns of serological markers in transfusion‐transmitted hepatitis C virus infection using second‐generation HCV assays
    Lelie, Lelie; Cuypers, Cuypers; Reesink, Reesink

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