Donation deferral criteria for human immunodeficiency virus positivity among blood donors in northern Thailand

Wat Uthaivoravit · Hideki Yanai · Khanchit Limpakarnjanarat · Timothy D. Mastro · Kenrad E. Nelson

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Blood donation and transfusion practices HIV/AIDS Research and Interventions HIV, Drug Use, Sexual Risk

Abstract

BACKGROUND: The purpose of this study was to develop human immunodeficiency virus (HIV) infection donation deferral criteria for blood donors in an HIV-epidemic area of northern Thailand, where the predominant means of transmission of HIV is through heterosexual contact. STUDY DESIGN AND METHODS: In a preliminary study, 2242 blood donors were interviewed, and their blood was tested for HIV antibodies between September 1993 and April 1994. The risk factors associated with HIV positivity were identified. Criteria to identify HIV-positive persons on the basis of a logistic equation were developed and applied to another group of 5769 prospective blood donors. RESULTS: A multivariate analysis showed the following odds ratios (OR) for traits that were independently associated with HIV positivity: younger age (OR = 0.93 for each additional year of age), male gender (OR = 2.41), having no more than a primary school education (OR = 2.00), being in the military (OR = 1.78), being unsure of one's own blood safety (OR = 2.00), history of injecting drug use (OR = 5.36), diagnosis of syphilis or positive syphilis serologic test in the past 12 months (OR = 2.67), and genital ulcer in the past 12 months (OR = 4.56). On the basis of the model, with a limit of <10 percent loss of uninfected donors, predicted probabilities of HIV positivity alone or of markers of infection with HIV, hepatitis B virus, or Treponema pallidum were calculated. With a cutoff of 6.5-percent estimated probability of HIV infection, derived from the logistic equation, the donor deferral criteria have 33.6-percent sensitivity and 8.3-percent positive predictive value for HIV positivity and 15.5-percent sensitivity and 18.4-percent positive predictive value for markers of infection with one of the three pathogens. CONCLUSION: The proposed donor deferral system provides a more flexible, sensitive, and predictive tool for averting donation by those who, though HIV antibody-negative, are at a higher risk of being infected with HIV.

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References

1989Impact of explicit questions about high‐risk activities on donor attitudes and donor deferral patterns. Results in two community blood centers 1995Infectious disease markers in blood donors in northern Thailand 1991Risk of transmission of HIV by seronegative blood

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2006Seroprevalence of sexually transmitted infections among accepted and deferred blood donors in Jamaica 1996An Estimate of the Number of Human Immunodeficiency Virus (HIV)-Positive Blood Donations by HIV-Seronegative Donors in a Northern Thailand HIV Epicenter 2014Impact of counseling on temporarily deferred donor in a tertiary care hospital, central India: A prospective study

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