title: Development of a multisystem surveillance database for transfusion-transmitted infections among blood donors in the United States.
abstract: The frequency of positive test results for transfusion-transmitted infections (TTIs) among blood donors is an important index of safety; thus, appropriate monitoring is critical, particularly when there are changes in policies affecting donor suitability.
  
  
  
  Testing algorithms from three large blood systems were reviewed and consensus definitions for a surveillance-positive result for hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and human T-cell lymphotropic virus (HTLV) established. In addition, information on each donation, including donor demographics and location, was collected. Combined data were analyzed to characterize the epidemiology of TTIs by person, place, and time.
  
  
  
  Data from 14.8 million donations were collected for 2011 to 2012, representing more than 50% of the US blood supply. Surveillance-positive rates per 10,000 donations were as follows: HBV, 0.76; HCV, 2.0; HIV, 0.28; and HTLV 0.34. Rates did not vary between the 2 years, although there was variation within a year. With the exception of HTLV, rates were higher among males, and all rates were higher among first-time donations. Window-period donations (those positive only in nucleic acid tests) were infrequent (HBV, 13; HCV, 60; HIV, 14) during the 2-year period. Frequencies of surveillance-positive results varied by donor age and residence location.
  
  
  
  We demonstrated that standardized data from multiple major US blood systems can be combined and analyzed for change. However, TTI frequencies are low, impacting their sensitivity to change. Furthermore, observed fluctuations in TTI frequencies may be secondary to changes in blood donor demographics rather than necessarily reflecting the immediate impact of policy modification.
authors.affiliation: Scientific Affairs, Holland Laboratory, American Red Cross, Rockville, Maryland.
authors.forename: Roger Y
authors.initials: RY
authors.lastname: Dodd
authors.affiliation: Scientific Affairs, Holland Laboratory, American Red Cross, Rockville, Maryland.
authors.forename: Edward P
authors.initials: EP
authors.lastname: Notari
authors.affiliation: Scientific Affairs, Holland Laboratory, American Red Cross, Rockville, Maryland.
authors.forename: Diane
authors.initials: D
authors.lastname: Nelson
authors.affiliation: Scientific Affairs, American Red Cross, Gaithersburg, Maryland.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Foster
authors.affiliation: Scientific Affairs, American Red Cross, Gaithersburg, Maryland.
authors.forename: David E
authors.initials: DE
authors.lastname: Krysztof
authors.affiliation: Blood Systems Research Institute, San Francisco, California.
authors.forename: Zhanna
authors.initials: Z
authors.lastname: Kaidarova
authors.affiliation: New York Blood Center, New York, New York.
authors.forename: Lisa
authors.initials: L
authors.lastname: Milan-Benson
authors.affiliation: New York Blood Center, New York, New York.
authors.forename: Debra A
authors.initials: DA
authors.lastname: Kessler
authors.affiliation: New York Blood Center, New York, New York.
authors.forename: Beth H
authors.initials: BH
authors.lastname: Shaz
authors.affiliation: Blood Systems Research Institute, San Francisco, California.
authors.forename: Farnaz
authors.identifier: 0000-0003-1130-4643
authors.initials: F
authors.lastname: Vahidnia
authors.affiliation: Blood Systems Research Institute, San Francisco, California.|Department of Laboratory Medicine, University of California at San Francisco, San Francisco, California.
authors.forename: Brian
authors.initials: B
authors.lastname: Custer
authors.affiliation: Scientific Affairs, American Red Cross, Gaithersburg, Maryland.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Stramer
mesh_terms: D001782:Blood Donors; D016208:Databases, Factual; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D008297:Male; D012737:Sex Factors; D065227:Transfusion Reaction; D014481:United States; D014777:Virus Diseases / Q000453:epidemiology / Q000635:transmission*