Risk of Window Period Hepatitis-C Infection in High Infectious Risk Donors: Systematic Review and Meta-Analysis

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1600-6143.2011.03460.x/abstract

Risk of Window Period Hepatitis-C Infection in High Infectious Risk Donors:

Systematic Review and Meta-Analysis

L. M. Kucirka1, H. Sarathy1, P. Govindan2, J. H. Wolf1, T. A. Ellison1, L. J.

Hart3, R. A. Montgomery1, R. L. Ros1, D. L. Segev1,4

Article first published online: 14 MAR 2011

DOI: 10.1111/j.1600-6143.2011.03460.x

© 2011 The Authors Journal compilation © 2011 The American Society of

Transplantation and the American Society of Transplant Surgeons

Issue

American Journal of Transplantation

Early View (Articles online in advance of print)

The OPTN classifies high infectious risk donors (HRDs) based on criteria

originally intended to identify people at risk for HIV infection. These donors

are sometimes referred to as ‘CDC high risk donors’ in reference to the

CDC-published guidelines adopted by the OPTN. However, these guidelines are also

being used to identify deceased donors at increased risk of window period (WP)

hepatitis C virus (HCV) infection, although not designed for this purpose. The

actual risk of WP HCV infection in HRDs is unknown. We performed a systematic

review of 3476 abstracts and identified 37 eligible estimates of HCV incidence

in HRD populations in the United States/Canada. Pooled HCV incidence was derived

and used to estimate the risk of WP infection for each HRD category. Risks

ranged from 0.26 to 300.6 per 10 000 donors based on WP for ELISA and 0.027 to

32.4 based on nucleic acid testing (NAT). Injection drug users were at highest

risk (32.4 per 10 000 donors by NAT WP), followed by commercial sex workers and

donors exhibiting high risk sexual behavior (12.3 per 10 000), men who have sex

with men (3.5 per 10 000), incarcerated donors (0.8 per 10 000), donors exposed

to HIV infected blood (0.4 per 10 000) and hemophiliacs (0.027 per 10 000). NAT

reduced WP risk by approximately 10-fold in each category.

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1600-6143.2011.03460.x/abstract

Risk of Window Period Hepatitis-C Infection in High Infectious Risk Donors:

Systematic Review and Meta-Analysis

L. M. Kucirka1, H. Sarathy1, P. Govindan2, J. H. Wolf1, T. A. Ellison1, L. J.

Hart3, R. A. Montgomery1, R. L. Ros1, D. L. Segev1,4

Article first published online: 14 MAR 2011

DOI: 10.1111/j.1600-6143.2011.03460.x

© 2011 The Authors Journal compilation © 2011 The American Society of

Transplantation and the American Society of Transplant Surgeons

Issue

American Journal of Transplantation

Early View (Articles online in advance of print)

The OPTN classifies high infectious risk donors (HRDs) based on criteria

originally intended to identify people at risk for HIV infection. These donors

are sometimes referred to as ‘CDC high risk donors’ in reference to the

CDC-published guidelines adopted by the OPTN. However, these guidelines are also

being used to identify deceased donors at increased risk of window period (WP)

hepatitis C virus (HCV) infection, although not designed for this purpose. The

actual risk of WP HCV infection in HRDs is unknown. We performed a systematic

review of 3476 abstracts and identified 37 eligible estimates of HCV incidence

in HRD populations in the United States/Canada. Pooled HCV incidence was derived

and used to estimate the risk of WP infection for each HRD category. Risks

ranged from 0.26 to 300.6 per 10 000 donors based on WP for ELISA and 0.027 to

32.4 based on nucleic acid testing (NAT). Injection drug users were at highest

risk (32.4 per 10 000 donors by NAT WP), followed by commercial sex workers and

donors exhibiting high risk sexual behavior (12.3 per 10 000), men who have sex

with men (3.5 per 10 000), incarcerated donors (0.8 per 10 000), donors exposed

to HIV infected blood (0.4 per 10 000) and hemophiliacs (0.027 per 10 000). NAT

reduced WP risk by approximately 10-fold in each category.

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1600-6143.2011.03460.x/abstract

Risk of Window Period Hepatitis-C Infection in High Infectious Risk Donors:

Systematic Review and Meta-Analysis

L. M. Kucirka1, H. Sarathy1, P. Govindan2, J. H. Wolf1, T. A. Ellison1, L. J.

Hart3, R. A. Montgomery1, R. L. Ros1, D. L. Segev1,4

Article first published online: 14 MAR 2011

DOI: 10.1111/j.1600-6143.2011.03460.x

© 2011 The Authors Journal compilation © 2011 The American Society of

Transplantation and the American Society of Transplant Surgeons

Issue

American Journal of Transplantation

Early View (Articles online in advance of print)

The OPTN classifies high infectious risk donors (HRDs) based on criteria

originally intended to identify people at risk for HIV infection. These donors

are sometimes referred to as ‘CDC high risk donors’ in reference to the

CDC-published guidelines adopted by the OPTN. However, these guidelines are also

being used to identify deceased donors at increased risk of window period (WP)

hepatitis C virus (HCV) infection, although not designed for this purpose. The

actual risk of WP HCV infection in HRDs is unknown. We performed a systematic

review of 3476 abstracts and identified 37 eligible estimates of HCV incidence

in HRD populations in the United States/Canada. Pooled HCV incidence was derived

and used to estimate the risk of WP infection for each HRD category. Risks

ranged from 0.26 to 300.6 per 10 000 donors based on WP for ELISA and 0.027 to

32.4 based on nucleic acid testing (NAT). Injection drug users were at highest

risk (32.4 per 10 000 donors by NAT WP), followed by commercial sex workers and

donors exhibiting high risk sexual behavior (12.3 per 10 000), men who have sex

with men (3.5 per 10 000), incarcerated donors (0.8 per 10 000), donors exposed

to HIV infected blood (0.4 per 10 000) and hemophiliacs (0.027 per 10 000). NAT

reduced WP risk by approximately 10-fold in each category.

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1600-6143.2011.03460.x/abstract

Risk of Window Period Hepatitis-C Infection in High Infectious Risk Donors:

Systematic Review and Meta-Analysis

L. M. Kucirka1, H. Sarathy1, P. Govindan2, J. H. Wolf1, T. A. Ellison1, L. J.

Hart3, R. A. Montgomery1, R. L. Ros1, D. L. Segev1,4

Article first published online: 14 MAR 2011

DOI: 10.1111/j.1600-6143.2011.03460.x

© 2011 The Authors Journal compilation © 2011 The American Society of

Transplantation and the American Society of Transplant Surgeons

Issue

American Journal of Transplantation

Early View (Articles online in advance of print)

The OPTN classifies high infectious risk donors (HRDs) based on criteria

originally intended to identify people at risk for HIV infection. These donors

are sometimes referred to as ‘CDC high risk donors’ in reference to the

CDC-published guidelines adopted by the OPTN. However, these guidelines are also

being used to identify deceased donors at increased risk of window period (WP)

hepatitis C virus (HCV) infection, although not designed for this purpose. The

actual risk of WP HCV infection in HRDs is unknown. We performed a systematic

review of 3476 abstracts and identified 37 eligible estimates of HCV incidence

in HRD populations in the United States/Canada. Pooled HCV incidence was derived

and used to estimate the risk of WP infection for each HRD category. Risks

ranged from 0.26 to 300.6 per 10 000 donors based on WP for ELISA and 0.027 to

32.4 based on nucleic acid testing (NAT). Injection drug users were at highest

risk (32.4 per 10 000 donors by NAT WP), followed by commercial sex workers and

donors exhibiting high risk sexual behavior (12.3 per 10 000), men who have sex

with men (3.5 per 10 000), incarcerated donors (0.8 per 10 000), donors exposed

to HIV infected blood (0.4 per 10 000) and hemophiliacs (0.027 per 10 000). NAT

reduced WP risk by approximately 10-fold in each category.