title: Window period donations during primary cytomegalovirus infection and risk of transfusion-transmitted infections.
abstract: BACKGROUND
  Donors with short interdonation intervals (e.g., apheresis donors) have an increased risk of window period donations. The frequency of cytomegalovirus (CMV) window period donations is important information to decide whether selection of seronegative donors might be advantageous for patients at risk for transfusion-transmitted CMV infections (TT-CMV).
  
  
  METHODS
  CMV seroconversion in 93 donors with positive results in routine CMV antibody testing within at most 35 days after the last seronegative sample was evaluated by Western blot and/or a second antibody test. In donors with unconfirmed seroconversion, an additional later sample was tested. Concentration of CMV DNA was determined in pre- and postseroconversion samples.
  
  
  RESULTS
  CMV seroconversion was confirmed in 12 donors (13%). Among these, the last seronegative sample was CMV DNA positive in three donors (25%, below 30 IU/mL). The first seropositive sample was CMV DNA positive in 10 donors (83%, maximum 1600 IU/mL). Both prevalence and median concentration of CMV DNA were higher in the first seropositive sample (p = 0.004 and p = 0.02), with maximum concentrations being reached about 2 weeks after seroconversion. No CMV DNA was detected in samples from donors with unconfirmed seroconversion.
  
  
  CONCLUSIONS
  At least in donors with short interdonation intervals, most suspected CMV seroconversions are due to false-positive results of the screening test. As window period donations are rare and contain less CMV DNA than the first seropositive donation, avoidance of blood products from primarily seropositive donors is especially helpful to avoid TT-CMV if donors with short interdonation intervals are concerned.
authors: Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Lübeck, Germany. Malte.Ziemann@uk-sh.de
authors: Malte
authors: M
authors: Ziemann
authors: Hans-Gert
authors: HG
authors: Heuft
authors: Kerstin
authors: K
authors: Frank
authors: Sabine
authors: S
authors: Kraas
authors: Siegfried
authors: S
authors: Görg
authors: Holger
authors: H
authors: Hennig
mesh_terms: D000914:Antibodies, Viral / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001782:Blood Donors; D058731:Blood Safety; D015153:Blotting, Western; D003587:Cytomegalovirus / Q000235:genetics / Q000276:immunology* / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000097:blood / Q000175:diagnosis / Q000517:prevention & control / Q000635:transmission*; D004279:DNA, Viral / Q000097:blood*; D005189:False Positive Reactions; D006801:Humans; D012189:Retrospective Studies; D012306:Risk
chemical_list: D000914:Antibodies, Viral; D015415:Biomarkers; D004279:DNA, Viral