A comparison of human immunodeficiency virus, hepatitis C virus, hepatitis B virus, and human T‐lymphotropic virus marker rates for directed versus volunteer blood donations to the American Red Cross during 2005 to 2010

Kerri A. Dorsey · Erin D. Moritz · Whitney Randolph Steele · Anne F. Eder · Susan L. Stramer

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Blood donation and transfusion practices Blood transfusion and management Organ Donation and Transplantation

Abstract

BACKGROUND: At most US blood centers, patients may still opt to choose specific donors to give blood for their anticipated transfusion needs. However, there is little evidence of improved safety with directed donation when compared to volunteer donation. STUDY DESIGN AND METHODS: The percentage of directed donations made to the American Red Cross (ARC) from 1995 to 2010 was determined. Infectious disease marker rates for human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV), and human T-lymphotropic virus (HTLV) were calculated for volunteer and directed donations made from 2005 to 2010. Odds ratios (ORs) were calculated to compare marker-positive rates of directed donations to volunteer donations. RESULTS: The percentage of donations from directed donors declined from 1.6% in 1995 to 0.12% in 2010. From 2005 to 2010, the ARC collected 38,894,782 volunteer and 69,869 directed donations. Rates of HIV, HCV, HBV, and HTLV for volunteer donations were 2.9, 32.2, 12.4, and 2.5 per 100,000 donations, respectively; for directed, the rates were 7.2, 93.0, 40.1, and 18.6 per 100,000. After demographics and first-time or repeat status were adjusted for, corresponding ORs of viral marker positivity in directed versus volunteer donations were not significant for HIV, HBV, or HTLV and significant for HCV (OR, 0.7; 95% confidence interval, 0.50-0.90). CONCLUSIONS: Directed donations have declined by 92% at the ARC since 1995, but have higher viral marker rates than volunteer donations. The difference can be explained in part by the effects of first-time or repeat status of the donors. Patients considering directed donation should be appropriately counseled about the potential risks.

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2010Prevalence, incidence, and residual risk of human immunodeficiency virus and hepatitis C virus infections among United States blood donors since the introduction of nucleic acid testing 2004Patterns of age‐ and sex‐specific prevalence of major blood‐borne infections in United States blood donors, 1995 to 2002: American Red Cross blood donor study 1989Markers for Transfusion-Transmitted Disease in Different Groups of Blood Donors 1986Experience with 11,916 designated donors 2010Prevalence, incidence, and residual risk of major blood‐borne infections among apheresis collections to the American Red Cross Blood Services, 2004 through 2008

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2023Patient Blood Management and Its Role in Supporting Blood Supply 2016Prevalence, incidence, and risk factors of human immunodeficiency virus infection in blood donors in the Southeastern United States 2022HIV, HTLV, and Hepatitis B and C Infection in Blood Donors in Bahia, Brazil from 2008 to 2017 2025Medical, Societal, and Ethical Considerations for Directed Blood Donation in 2025 2021Directed Donation: Special Considerations and Review for Contemporary Clinical Practices 2017Parental versus non‐parental–directed donation: an 11‐year experience of infectious disease testing at a pediatric tertiary care blood donor center

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