Estimate of the residual risk of transfusion-transmitted human immunodeficiency virus infection in sub-Saharan Africa: a multinational collaborative study.
BACKGROUND
Sub-Saharan Africa remains the epicenter of the human immunodeficiency virus (HIV) pandemic. However, there is a lack of multicenter data on the risk of transfusion-transmitted HIV from blood centers in sub-Saharan Africa.


METHODS
The incidence of HIV infections in the blood donations collected in the main blood banks of five countries (Burkina Faso, Congo, Ivory Coast, Mali, and Senegal) was determined to estimate the current transfusion risk of HIV infection using the incidence rate/window period model.


RESULTS
The risk of transfusion-transmitted HIV infections associated with the window period varied from 1 in 90,200 donations (Senegal) to 1 in 25,600 (Congo). Considering the five participating blood centers as a whole, the incidence rate of HIV-positive donors per 100,000 person-years was 56.6 (95% confidence interval [CI], 47.1-67.9); the residual risk (RR) was 34.1 (95% CI, 7.8-70.7) per 1 million donations, which represents 1 in 29,000 donations (95% CI, 1/128,000-1/14,000).


CONCLUSIONS
RR estimates varied according to the country. This is potentially due to a lower incidence of HIV infection in the general population or to a more efficient selection of blood donors in the countries with the lowest risk. The estimates of the transfusion risk of HIV infection in each country are important, both to assess the impact of current preventative strategies and to contribute data to policy decisions to reinforce transfusion safety.
Lefrère
Jean-Jacques
JJ
National Blood Transfusion Institute, Paris, France; the Laboratory of Hematology, University Teaching Hospital, Amiens, France.
Dahourouh
Honorine
H
Dokekias
Alexis E
AE
Kouao
Maxime D
MD
Diarra
Amadou
A
Diop
Saliou
S
Tapko
Jean-Baptiste
JB
Murphy
Edward L
EL
Laperche
Syria
S
Pillonel
Josiane
J
D017954:Africa South of the Sahara; D015658:HIV Infections / Q000635:transmission*; D006801:Humans; D007391:International Cooperation; D012306:Risk; D065227:Transfusion Reaction