Residual Risk of HIV in African Transfusional Setting: Systematic Review and Meta-Analysis
International STD Research & Reviews,
Context: The residual risk of HIV transmission is still a real problem into the transfusional settings of limited resources countries. Blood banks of African countries confront the risk of transmitting HIV to recipients. The objective of this study is to estimate the residual risk of HIV in African transfusion settings and to compare this residual risk with that of other countries in the South (developping countries).
Methods: This study resulted of a systematic review with meta-analysis of data from several comprehensive studies carried out between 2011 and 2017 whose purpose was focused on the residual risk of HIV transmission through blood transfusion. The studies on the residual risk were systematically searched in the different databases (PubMed, Medline and Google Scholar). The eligibility criteria were based on published studies which had blood donors as participants, looking at the residual risk of HIV in developing countries and the technique was based on the search for antibodies-P24 Antigen of the HIV or on nucleic acid (RNA) testing. Studies carried out before 2011 and after 2017 were excluded. Studies in rich countries were also excluded. The Cochrane tool was used to assess the risk of bias.
Results: A total of 327,278 seronegative donors (for 12 eligible studies) were admitted for this study, i.e. 75.5% of men and 24.5% of women. The median age of all donors was 30.4 years. For studies carried out in the Africa zone (Burkina Faso, Ivory Coast, Nigeria, Democratic Republic of Congo, Tanzania and Zimbabwe), 327,278 donors were initially seronegative, of which 626 were found to be positive. Indeed, out of 742 incident cases in this study from African countries and other countries of the South, 84.4% of positive donors came from African studies and 15.6% of positive donors came from other countries of the South in this study. The residual risk (RR) of HIV in Africa has been estimated at 13 per 1,000,000 donations, with an incidence rate (IR) of 21.5 per 100,000 person-years. And in the other countries of the South (Brazil, Croatia, India, Iran, Malaysia and Pakistan), the RR of HIV has been estimated at 0.6 per 1,000,000 donations, or an incidence rate of 1.1 per 100,000 person-years.
Conclusion: The residual risk of HIV in the transfusion environment is still high and still persists in blood banks in southern countries in general and in Africa in particular.
- blood transfusion
- residual risk
How to Cite
Weimer A, Tagny CT, Tapko JB, Gouws C, Tobian AAR, Ness PM, et al. Blood transfusion safety in sub-Saharan Africa: A literature review of changes and challenges in the 21st century. Transfusion. 2019;59:412-427.
DOI : 10.1111/trf.14949
Pessoni LL, Aquino EC de, Alcântara KC de. Prevalence and trends in transfusion-transmissible infections among blood donors in Brazil from 2010 to 2016. Hematol transfus cell ther. 2019;41:310-315.
Ware AD, Jacquot C, Tobian AAR, Gehrie EA, Ness PM, Bloch EM. Pathogen reduction and blood transfusion safety in Africa: Strengths, limitations and challenges of implementation in low-resource settings. Vox Sanguinis. 2017;113:3–12.
Dodd RY, Crowder LA, Haynes JM, Notari EP, Stramer SL, Steele WR. Screening blood donors for HIV, HCV and HBV at the American red Cross: Ten-Year Trends in Prevalence, Incidence and Residual Risk, 2007–2016. Transfusion Medicine Reviews. 2020;34:81-93.
Levi JE, Lira SM, Bub CB, Polite MB, Terzian CC, Kutner JM. Contrasting HCV and HIV seroepidemiology in 11 years of blood donors screening in Brazil. Transfusion Medicine [Internet]. Wiley. 2017;27(4):286–91.
Aramani SS, Bommanahalli BP, Kammar SM. Efficacy of nucleic acid amplification test (NAT) over enzyme linked immuno sorbent assay (ELISA) in detecting transfusion transmissible infections (TTI) among blood donors at a tertiary care centre. Annals of Pathology and Laboratory Medicine [Internet]. Marwah Infotech. 2019;6(4):A244–247.
Baruah S, Pal L. Seven years experience in NAT testing of blood donors in a tertiary care centre. International Journal of Contemporary Medical Research [IJCMR] [Internet]. Marwah Infotech. 2019;6(7).
Degefa B, Gebreeyesus T, Gebremedhin Z, et al. Prevalence of hepatitis B virus, hepatitis C virus, and human immunodeficiency virus among blood donors of Mekelle blood bank, Northern Ethiopia: A three-year retrospective study. Journal of Medical Virology. 2018;90:1724-29.
Morar MM, Pitman JP, McFarland W, Bloch EM. The contribution of unsafe blood transfusion to human immunodeficiency virus incidence in sub-Saharan Africa: reexamination of the 5% to 10% convention. Transfusion [Internet]. Wiley. 2016 ;56(12):3121–32.
DOI : org/10.1111/trf.13816
Barro L, Drew VJ, Poda GG, Tagny CT, El-Ekiaby M, Owusu-Ofori S, et al. Blood transfusion in sub-Saharan Africa: Understanding the missing gap and responding to present and future challenges. Vox Sanguinis. 2018;113:726-736.
Al-Zubiery TK, Alsumairy H, Alharazi T, et al. Seroprevalence of Human Immunodeficiency Virus (HIV) among blood donors attending national blood transfusion and research center in Sana'a City, Yemen: Warning sign. International STD Research & Reviews. 2018;7: 1-7.
Nambei WS, Rawago-Mandjiza D, Gbangbangai E. Seroepidemiology of HIV, syphilis and hepatitis B and C viruses among blood donors in Bangui, Central African Republic. Tropical Health Medicine. 2016;26:192-198.
De Oliveira F, Mourez T, Vessiere A, Ngoupo PA, Alessandri‑Gradt E, Simon F, Rousset D, Jean‑Christophe Plantier JC. Multiple HIV‑1/M + HIV‑1/O dual infections and new HIV‑1/MO inter‑group recombinant forms detected in Cameroon. Retrovirology. 2017;14:1-12.
Olusola BA, Olaleye DO, Odaibo GN. New infections and HIV‐1 subtypes among febrile persons and blood donors in Oyo State, Nigeria. Journal of Medical Virology ; 2021.
Page MJ, McKenzie J, Bossuyt P, Boutron I, Hoffmann T, Mulrow Cindy d, et al. Updating guidance for reporting systematic reviews: Development of the PRISMA 2020 statement. Center for Open Science ; 2020.
Tetzlaff J, Page M, Moher D. PNS154 the prisma 2020 statement: Development of and key changes in an updated guideline for reporting systematic reviews and meta-analyses. Value in health. Elsevier bv. 2020;23:S312–S313.
Olowe OA, Mabayoje VO , Akanbi O, Adefioye OJ, Olowe RA, Fadeni EK, Oluremi AS, Opaleye OO. HIV P24 antigen among HIV antibody seronegative blood donors in Osogbo Osun State, South Western Nigeria. Pathogens and Global Health. 2016;110:205–208.
Adetunji AA, Kuti MA, Audu RA, Muyibi SA, Imhansoloeva M, Mosuro OA, Solanke EA, et al. Discordant rapid HIV tests : Lessons from a low-resource community. HIV Med. 2018;19:72–76.
Mwenebitu David L, Mabaya Gael B, Christian P, et al. Risk factors of the transmission of the HIV, Hepatitis B and C and syphilis among blood donors at the saint luc general hospital of kisantu, democratic republic of congo. Journal of HIV & Retro Virus. 2018 ;4:18-22.
Aprahamian H, Bish DR, Bish EK. Residual risk and waste in donated blood with pooled nucleic acid testing. Statistics in Medicine. 2016;35:5283–5301.
Hu Y. Molecular techniques for blood and blood product screening. Advanced Techniques in Diagnostic Microbiology. 2018;10:31–66.
Marwaha N, Hans R, Sharma S, Sachdev S, Sharma R. Initial trends of individual donation nucleic acid testing in voluntary and replacement donors from a tertiary care centre in north India. Indian Journal of Medical Research [Internet]. Medknow. 2019;149:633.
Vermeulen M, Lelie N, Coleman C, Sykes W, Jacobs G, Swanevelder R et al. Assessment of HIV transfusion transmission risk in South Africa: a 10-year analysis following implementation of individual donation nucleic acid amplification technology testing and donor demographics eligibility changes. Transfusion. 2018;59:267-276.
Rocha D, Andrade E, Godoy DT, Fontana-Maurell M, Costa E, Ribeiro M, et al. The Brazilian experience of nucleic acid testing to detect human immunodeficiency virus, hepatitis C virus, and hepatitis B virus infections in blood donors. Transfusion [Internet]. Wiley. 2018;58(4):862-70.
Pessôa R, Loureiro P, Esther Lopes M, Carneiro-Proietti ABF, Sabino EC, Busch MP, Sanabani SS. Ultra-deep sequencing of HIV-1 near full-length and partial proviral genomes reveals high genetic diversity among brazilian blood donors. PLOS ONE. 2016;11:e0152499.
Wongjarupong N, Oli S, Sanou M, Djigma F, Kiba Koumare A, Yonli AT, et al. Distribution and incidence of blood-borne infection among blood donors from regional transfusion centers in Burkina Faso : A comprehensive study. The American Journal of Tropical Medicine and Hygiene [Internet]. American Society of Tropical Medicine and Hygiene. 2021;104:1577–81.
Birhaneselassie M. Prevalence of transfusion-transmissible infections in donors to an ethiopian blood bank between 2009 and 2013 and donation factors that would improve the safety of the blood supply in underdeveloped countries. Laboratory Medicine. 2016;47:134–139.
Keleta YT, Achila OO, Haile AW, Gebrecherkos BH, Tesfaldet DT, Teklu KS, Mohammed MA, Ghedel ST. Seroprevalence of transfusion transmitted infections among blood donors in Gash Barka Zonal Blood Transfusion Center, Barentu, Eritrea, 2014 through 2017. BMC Hematol. 2019;19:5-14.
Ilumbulumbu M, Ketha J, Tshimanga V, Bunduki G, Valimungighe M, Kitamwivirirwa T, Visavingi S, Sikakulya F, Mitamo A. High prevalence of transfusion-transmissible infections among volunteer blood donors in rural area of Eastern Democratic Republic of the Congo (D.R.C). Archives of Current Research International. 2018;14:1-8.
M’baya B, Jumbe V, Samuel V, M’bwana R, Mangani C. Seroprevalence and trends in transfusion transmissible infections among voluntary non-remunerated blood donors at the Malawi Blood Transfusion Service-a time trend study. Malawi Medical Journal. 2019;31:118-125.
Okoroiwu HU, Okafor IM, Asemota EA, Okpokam DC. Seroprevalence of transfusion-transmissible infections (HBV, HCV, syphilis and HIV) among prospective blood donors in a tertiary health care facility in Calabar, Nigeria ; an eleven years evaluation. BMC Public Health. 2018;18:645-653.
Candotti D, Sauvage V, Cappy P, Boullahi MA, Bizimana P, Mbensa GO, et al. High rate of hepatitis C virus and human immunodeficiency virus false‐positive results in serologic screening in sub‐Saharan Africa: Adverse impact on the blood supply. Transfusion [Internet]. Wiley. 2019;60(1):106–16.
Dadzie I, Muniru S, Adu P, Cudjoe O. Nucleic acid amplification testing detects HIV transmission risk in serologically-tested blood donor units. Journal of Clinical and Diagnostic Research. 2018;12:DC22-DC24.
Yooda AP, Sawadogo S, Soubeiga ST, Obiri-Yeboah D, Nebie K, Ouattara AK, Simpore J. Residual risk of HIV, HCV, and HBV transmission by blood transfusion between 2015 and 2017 at the Regional Blood Transfusion Center of Ouagadougou, Burkina Faso. Journal of Blood Medicine. 2019;10:53–58.
Dongmo EG, Nsagha DS, Zofou D, Longdoh Njunda A, Nanfack AJ, Fokam J Tayou Tagny C. Residual risk of HIV transmission through blood transfusion in five blood banks in Cameroon. The Journal of Medical Research. 2020;6:158-165.
Souza JC, Crispim MAE, Abrahim C, Fraiji NA, Kiesslich D, Stefani MMA. High rate of seromarkers for HIV, HBV and syphilis among blood donors using confidential unit exclusion, before and after HIV‐NAT implementation at a major public blood bank in the Brazilian Amazon. Transfusion [Internet]. Wiley. 2018;59(2):629–38.
Pawar A, Jagani R, Dimri U, Kumar S. Experience of individual donor nucleic acid testing on screening of blood donors for human immunodeficiency virus, Hepatitis C Virus, and Hepatitis B Virus at an Apex blood bank of Northern India. Medical Journal of Dr DY Patil Vidyapeeth [Internet]. Medknow. 2021;0(0):0.
Vieira PCM, Lamarao LM, Amaral CEM, Correa ASM, Lima MSM, Barile KAS, Almeida KLD, Sortica VA, Kayath AS, Burbano RMR. Residual risk of transmission of human immunodeficiency virus and hepatitis C virus infections by blood transfusion in northern Brazil. Transfusion. 2017;57:1968–1976.
Mathur A, Dontula S, Jagannathan L. A study of centralized individual donor nucleic acid testing for transfusion transmitted infections to improve blood safety in Karnataka, India. Glob J Transfus Med. 2017;2:24-32.
Mishra KK, Trivedi A, Sosa S, Patel K, Ghosh K. NAT positivity in seronegative voluntary blood donors from western India. Transfusion and Apheresis Science. 2017;56:175–178.
Yooda AP, Soubeiga ST, Yacouba Nebie K, Diarra B, Sawadogo S, Ouattara AK, Obiri-Yeboah D, Yonli AT, Tao I, Sorgho PA, Dahourou H, Simpore J. Impact of multiplex PCR in reducing the risk of residual transfusion-transmitted human immunodeficiency and hepatitis B and C viruses in Burkina Faso. Mediterr J Hematol Infect Dis. 2018;10:e2018041.
O’Brien SF, Yi Q-L, Fan W, Scalia V, Goldman M, Fearon MA. Residual risk of HIV, HCV and HBV in Canada. Transfusion and Apheresis Science [Internet]. Elsevier BV. 2017;56(3):389–91.
Steele WR, Dodd RY, Notari EP, Haynes J, Anderson SA, Williams AE, et al. HIV, HCV, and HBV incidence and residual risk in US blood donors before and after implementation of the 12‐month deferral policy for men who have sex with men. Transfusion [Internet]. Wiley. 2021;61(3): 839–50.
Abstract View: 123 times
PDF Download: 49 times