Thu May 19, 2016 11:23 am (PDT) . Posted by:
*A prospective evaluation of chronic /Babesia microti/ infection in
seroreactive blood donors*
Bloch, E. M., Levin, A. E., Williamson, P. C., Cyrus, S., Shaz, B. H.,
Kessler, D., Gorlin, J., Bruhn, R., Lee, T.-H., Montalvo, L., Kamel, H.
and Busch, M. P.
/Transfusion/, online first May 17, 2016.
http://doi.org/10.1111/trf.13617
Abstract
*BACKGROUND*
/Babesia microti/ is the foremost infectious risk to the US blood supply
for which a Food and Drug Administration (FDA)-licensed test is
unavailable for donation screening. Characterization of the antibody
response to /B. microti/ and correlation with parasitemia is necessary
to guide screening and donor management policies.
*STUDY DESIGN AND METHODS*
During an FDA licensure trial, blood donors were prospectively screened
(July-November 2013) using a /B. microti-/specific antibody enzyme
immunoassay (EIA, Immunetics) in highly endemic (New York [NY];
n = 13,688), moderately endemic (Minnesota [MN]; n = 4583), and
nonendemic (New Mexico [NM]; n = 8451) regions. Blood donors with
repeat-reactive (RR) results participated in a 12-month prospective
cohort study using /B. microti/ EIA, immunofluorescent assay, polymerase
chain reaction (PCR), blood smear, and clinical questionnaire.
*RESULTS*
Thirty-seven (61.67%; 24 NY, seven MN, six NM) of 60 eligible RR donors
enrolled in the study; 20 of 37 (54%) completed the 12-month follow-up
visit of which 15 (75%) were still seroreactive. Nine PCR-positive
donors were identified during index screening; five participated in the
follow-up study, three were PCR positive at 6 months, and two remained
positive at final follow-up (378 and 404 days). Most RR donors displayed
low-level seroreactivity that was either stable or waning during
follow-up. The level and pattern of reactivity correlated poorly with
PCR positivity.
*CONCLUSION*
The findings indicate prolonged seropositivity in blood donors. Although
rare, asymptomatic, persistent PCR positivity supports the current
policy of indefinite deferral for donors with a history of babesiosis or
positive test results. Repeat testing by PCR and serology will be
necessary if reinstatement is to be considered.
http://doi.org/10.1111/trf.13617
seroreactive blood donors*
Bloch, E. M., Levin, A. E., Williamson, P. C., Cyrus, S., Shaz, B. H.,
Kessler, D., Gorlin, J., Bruhn, R., Lee, T.-H., Montalvo, L., Kamel, H.
and Busch, M. P.
/Transfusion/, online first May 17, 2016.
http://doi.org/10.1111/trf.13617
Abstract
*BACKGROUND*
/Babesia microti/ is the foremost infectious risk to the US blood supply
for which a Food and Drug Administration (FDA)-licensed test is
unavailable for donation screening. Characterization of the antibody
response to /B. microti/ and correlation with parasitemia is necessary
to guide screening and donor management policies.
*STUDY DESIGN AND METHODS*
During an FDA licensure trial, blood donors were prospectively screened
(July-November 2013) using a /B. microti-/specific antibody enzyme
immunoassay (EIA, Immunetics) in highly endemic (New York [NY];
n = 13,688), moderately endemic (Minnesota [MN]; n = 4583), and
nonendemic (New Mexico [NM]; n = 8451) regions. Blood donors with
repeat-reactive (RR) results participated in a 12-month prospective
cohort study using /B. microti/ EIA, immunofluorescent assay, polymerase
chain reaction (PCR), blood smear, and clinical questionnaire.
*RESULTS*
Thirty-seven (61.67%; 24 NY, seven MN, six NM) of 60 eligible RR donors
enrolled in the study; 20 of 37 (54%) completed the 12-month follow-up
visit of which 15 (75%) were still seroreactive. Nine PCR-positive
donors were identified during index screening; five participated in the
follow-up study, three were PCR positive at 6 months, and two remained
positive at final follow-up (378 and 404 days). Most RR donors displayed
low-level seroreactivity that was either stable or waning during
follow-up. The level and pattern of reactivity correlated poorly with
PCR positivity.
*CONCLUSION*
The findings indicate prolonged seropositivity in blood donors. Although
rare, asymptomatic, persistent PCR positivity supports the current
policy of indefinite deferral for donors with a history of babesiosis or
positive test results. Repeat testing by PCR and serology will be
necessary if reinstatement is to be considered.
http://doi.org/10.1111/trf.13617
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