title: Genetic diversity of recently acquired and prevalent HIV, hepatitis B virus, and hepatitis C virus infections in US blood donors.
abstract: BACKGROUND
  Genetic variations of human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV) can affect diagnostic assays and therapeutic interventions. Recent changes in prevalence of subtypes/genotypes and drug/immune-escape variants were characterized by comparing recently infected vs more remotely infected blood donors.
  
  
  METHODS
  Infected donors were identified among approximately 34 million US blood donations, 2006-2009; incident infections were defined as having no or low antiviral antibody titers. Viral genomes were partially sequenced.
  
  
  RESULTS
  Of 321 HIV strains (50% incident), 2.5% were non-B HIV subtypes. Protease and reverse transcriptase (RT) inhibitor resistance mutations were found in 2% and 11% of infected donors, respectively. Subtypes in 278 HCV strains (31% incident) yielded 1a>1b>3a>2b>2a>4a>6d, 6e: higher frequencies of 3a in incident cases vs higher frequencies of 1b in prevalent cases were found (P = .04). Twenty subgenotypes among 193 HBV strains (26% incident) yielded higher frequencies of A2 in incident cases and higher frequencies of A1, B2, and B4 in prevalent cases (P = .007). No HBV drug resistance mutations were detected. Six percent of incident vs 26% of prevalent HBV contained antibody neutralization escape mutations (P = .01).
  
  
  CONCLUSIONS
  Viral genetic variant distribution in blood donors was similar to that seen in high-risk US populations. Blood-borne viruses detected through large-scale routine screening of blood donors can complement molecular surveillance studies of highly exposed populations.
authors.affiliation: Blood Systems Research Institute, San Francisco, CA, USA. delwarte@medicine.ucsf.edu
authors.forename: Eric
authors.initials: E
authors.lastname: Delwart
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Slikas
authors.forename: Susan L
authors.initials: SL
authors.lastname: Stramer
authors.forename: Hany
authors.initials: H
authors.lastname: Kamel
authors.forename: Debra
authors.initials: D
authors.lastname: Kessler
authors.forename: David
authors.initials: D
authors.lastname: Krysztof
authors.forename: Leslie H
authors.initials: LH
authors.lastname: Tobler
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Carrick
authors.forename: Whitney
authors.initials: W
authors.lastname: Steele
authors.forename: Deborah
authors.initials: D
authors.lastname: Todd
authors.forename: David J
authors.initials: DJ
authors.lastname: Wright
authors.forename: Steven H
authors.initials: SH
authors.lastname: Kleinman
authors.forename: Michael P
authors.initials: MP
authors.lastname: Busch
mesh_terms: D000328:Adult; D000368:Aged; D001782:Blood Donors; D024882:Drug Resistance, Viral; D005260:Female; D014644:Genetic Variation; D016679:Genome, Viral; D006678:HIV / Q000235:genetics; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D016174:Hepacivirus / Q000235:genetics; D006509:Hepatitis B / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D006515:Hepatitis B virus / Q000235:genetics; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D017422:Sequence Analysis, DNA; D013048:Specimen Handling / Q000379:methods; D055815:Young Adult