HIV Infection Among Potential Blood Donors

The statistics on HIV in Russia in 2013 were studied and compared with the blood service data. It was found that among different contingents the minimum detection rate of HIV infection has been registered among blood donors. Maximum detection rate of HIV among men, who have sex with men, actualizes the need for a ban on their participation in blood donation. The detection rate of HIV among donors, as well as the ratio of detection of HIV among donors and other categories surveyed indicate a lack of efficiency of formation of donor contingent of supporters of a healthy lifestyle. A direct positive correlation of HIV was detected in blood donors and region population, the volume of blood processing, as well as all volumes of blood wastage due to markers of blood borne infections except the volume due to HBs-antigen. HIV Infection Among Potential Blood Donors


Introduction
HIV transmission to a recipient is the most resonant adverse effect of blood transfusion [1]. From HIV infection epidemics onset and up to 2013 inclusive, 80 cases of HIV infection transmission during transfusion of fresh frozen plasma and blood products were registered in the Russian Federation. Since 2010, two such cases have been registered annually. In 2012-2013 the key reason for infection transmission during blood transfusion was red blood cell suspension transfusion from active donors in the seronegative period (Smolensk, Kemerovo regions). In March 2013 in St. Petersburg a child was transfused with red blood cells prior to donor's HIV infection test results were received [2].
HIV infection prevention should be undertaken comprehensively as regards sources of the virus, mechanisms, routes and factors of transmission as well as sensitive population, including representatives of vulnerable groups of population [3].
It would be interesting to compare HIV detectability in donors with similar characteristics in other population groups both on regional and national scale.

Materials and Methods
The following materials have been studied: The results were evaluated using descriptive statistics and correlation analysis with the level of significance of 0.05.

Results and Discussion
The number of HIV infected persons who applied to a donor point was minimal among the groups examined (Table 1). However, as shown in Table 1, the number of seropositives per 100,000 of serum samples was maximum in MSM group. The possibility to lift the ban for men practicing sex with other men is widely discussed on the international level [5]. The observed maximum infection detectability rate in this group makes actual the need to introduce the same ban in Russia.
The maximum HIV detectability rate among donors is in the regions with the highest overall HIV detectability rate ( Table 2). Median and interquartile interval of this parameter made 7.9% (4.5-15.7) in 2012 and 9.0% (5.9-13.1) in 2013. In the regions with the highest value for this parameter, special attention should be paid to recruitment of donors without any HIV infection risk ( Table 6).
The correlation relationship of HIV detectability in donors and other groups examined (Table 7) demonstrates epidemic process similarity among potential donors and the population in general, save for those who were examined during epidemiologic investigation and foreign subjects.
The drawback of this study is generalization of the results of new and regular donor examination. Usually the blood service identifies two infection safety indicators: blood transmission infection incidence and occurrence rate. Incidence, or prevalence, is the number of cases of a certain disease among the population at a certain moment. In blood transfusion it means the number of diseases among new donors (usually, per annum).      Occurrence rate is the number of cases of a disease occurring during a certain period of time in a certain population. In blood transfusion it means disease finding in regular donors [6].
In this study it is not possible to differentiate between the results for new and regular donors.
HIV detectability in donors demonstrates positive correlation with all parameters of blood rejection rate using blood transmitted infection markers (Table 8). The only exception is the blood rejection rate on HBs antigen, where no correlation is present. We may assume the identity of transmission mechanisms of HIV, HCV and syphilis as well as liver lesions as a result of alcohol consumption among persons with deviant behaviour who apply to a donor point. Positive HIV test results are more common for large regions and centres with the highest blood collection rates.

Conclusions
1. It was found that among different contingents the minimum detection rate of HIV infection in regions of the Russian Federation in 2013 has been registered among blood donors.
2. Maximum detection rate of HIV among men practicing sex with men actualizes the need for a ban on their participation in blood donation.
3. The detection rate of HIV among donors, as well as the ratio of detection of HIV among donors and other categories surveyed indicate a lack of efficiency of formation of donor contingent of supporters of a healthy lifestyle.

A direct positive correlation detection of HIV in blood donors
and region population, the volume of blood processing, as well as all volumes of blood wastage due to markers of bloodborne infections except the volume due to HBs-antigen.  Blood rejection due to HCV, l 0.43 Cell production for blood components, l 0.41 Cell production by centrifugation, l 0.40 Cell production from blood, l 0.40 Population of the RF constituent territory 0.40 Positions involved in blood collection 0.40