title: Metagenomic profiling of the viromes of plasma collected from blood donors with elevated serum alanine aminotransferase levels.
abstract: BACKGROUND
  In Japanese Red Cross (JRC) blood centers, blood collected from donors with serum alanine aminotransferase (ALT) levels of more than 60 U/L are disqualified even if serologically negative for transfusion-transmitted infections (TTIs). To assess potential risks of TTIs in plasma with elevated serum ALT levels in the current donor screening program of the JRC, we conducted a metagenomic analysis (MGA) of virome profiles in the plasma of blood donors with or without elevated serum ALT levels.
  
  
  METHODS
  Based on serum ALT levels, donors were classified into three groups: "high," more than 79 U/L; "middle," 61 to 79 U/L; and "low," less than 61 U/L. We individually analyzed 100 plasma samples from each group by MGA, employing shotgun sequencing. Viral sequences detected using MGA were partly confirmed using real-time polymerase chain reaction (PCR).
  
  
  RESULTS
  Donors with high and middle ALT levels were significantly younger than those with low ALT levels, and more than 90% were males. Herpesviridae, Anelloviridae, Picornaviridae, and Flaviviridae sequences were identified in plasma samples, and their distribution and frequency were not significantly different among the three groups.
  
  
  CONCLUSIONS
  The serum ALT test may be unsuitable for monitoring for additional risks of TTIs in blood donors who were negative for typical TTIs using serologic and nucleic acid tests. Although MGA is less sensitive than PCR, it remains the best technology to detect known viruses in these donors.
authors.affiliation: Japanese Red Cross Kinki Block Blood Center, Osaka, Japan.
authors.forename: Rika A
authors.initials: RA
authors.lastname: Furuta
authors.affiliation: Japanese Red Cross Kinki Block Blood Center, Osaka, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Sakamoto
authors.affiliation: Japanese Red Cross Kinki Block Blood Center, Osaka, Japan.
authors.forename: Ayumu
authors.initials: A
authors.lastname: Kuroishi
authors.affiliation: Japanese Red Cross Kinki Block Blood Center, Osaka, Japan.
authors.forename: Kazuta
authors.initials: K
authors.lastname: Yasiui
authors.affiliation: Japanese Red Cross Kinki Block Blood Center, Osaka, Japan.
authors.forename: Harumichi
authors.initials: H
authors.lastname: Matsukura
authors.affiliation: Japanese Red Cross Kinki Block Blood Center, Osaka, Japan.
authors.forename: Fumiya
authors.initials: F
authors.lastname: Hirayama
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D049811:Anelloviridae / Q000235:genetics / Q000302:isolation & purification; D001782:Blood Donors; D058731:Blood Safety; D017848:Blood-Borne Pathogens; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D018067:Flaviviridae / Q000235:genetics / Q000302:isolation & purification; D016679:Genome, Viral; D006564:Herpesviridae / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D056186:Metagenomics / Q000379:methods*; D008875:Middle Aged; D010849:Picornaviridae / Q000235:genetics / Q000302:isolation & purification; D010949:Plasma / Q000821:virology*; D012367:RNA, Viral / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D017423:Sequence Analysis, RNA; D014766:Viremia / Q000201:enzymology / Q000821:virology; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D012367:RNA, Viral; D000410:Alanine Transaminase