Detection of Influenza A(H3N2) Virus RNA in Donated Blood.

Influenza A virus infection has rarely been documented to cause viremia. In 28 blood donations in Brazil that were deferred because of postdonation information, we identified influenza A(H3N2) virus RNA in 1 donation using metagenomic analysis. Our finding implies theoretical risk for viremia and transfusion transmission.

"Molecular analysis of the rare S-s- red blood cell phenotype in blood donors and patients in south-east Brazil".

BACKGROUND AND OBJECTIVES: The rare S-s- phenotype has two main molecular backgrounds. GYPB deletions give rise to the S-s-U- phenotype, which loses the expression of the U antigen, while variant GYPB alleles usually lead to the S-s-U+var phenotype, which express a variant U antigen. The S-s- phenotype is typically found in people of African origin and represents a challenge in transfusion sets, especially when S-s- patients develop anti-U. Molecular analysis is the most reliable method for determining U antigen status. We studied the molecular basis of the S-s- phenotype in donors and patients at Regional Blood Center of Ribeirão Preto. MATERIAL AND METHODS: Five patients and 25 donors with the S-s- phenotype were investigated through real-time PCR for the GYPB*S/s polymorphism, followed by an allele-specific/RFLP-PCR for GYPB deletion (GYPB*Null) and for its main variants: GYPB*P2 and GYPB*NY. DNA sequencing was conducted in one sample. RESULTS: Two samples were heterozygous GYPB*P2/GYPB*NY, eight were homozygous/hemizygous for GYPB*P2 and 19 samples were homozygous for GYPB*Null. A hybrid gene (GYPB-E-B.Ros) was found in one sample after discrepant results in the initial tests. CONCLUSION: GYPB deletion is the main mechanism responsible for the S-s- phenotype in our donors and patients. It is essential to evaluate the main GYPB variant alleles when genotyping in order to obtain the correct prediction of the phenotype. Hybrid genes lead to discrepancies between genotype and phenotype and may not be detected by conventional molecular assays.

Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular Consensus on genetically modified cells. VI: Accreditation process.

The adherence to accreditation programs proves the institutions' voluntary effort to pursue the quality and safety of their products and services by meeting internationally accepted standards audited by experts in the field, external to the service. Meeting such standards often exceeds domestic legal requirements. However, service providers are not released from complying with the legal requirements, both local and international, pertinent to the field. Accreditation programs use the precepts of the quality management system to validate and standardize processes, monitor results through quality control, proficiency testing, and indicators, and perform risk management. For cellular therapy services, the assessing agencies available in our field are the AABB/ABHH (American Association of Blood Banks/Brazilian Association of Hematology, Hemotherapy and Cellular Therapy) and FACT-JACIE (Foundation for the Accreditation of Cellular Therapy-Joint Accreditation Committee, ISCT/EBMT). Both agencies require that the accredited organization meets all the standards defined in each program. Applying services also have to establish and comply with a quality management standard that demonstrates procedural interrelationship to ensure product and service quality. This paper aims to concisely outline the essential features of those two accreditation programs, along with a brief overview of the accreditation process under each of them.

Prevalence of Trypanosoma Cruzi antibodies in blood donors from the Sao Paulo State, Brazil, between 2012 and 2014.

INTRODUCTION: American tripanosomiasis (Chagas disease), the second most neglected disease in the world, is caused by the protozoan parasite Trypanosoma cruzi. Though natural transmission by insect vectors has been controlled, there is significant risk of T. cruzi transmission by blood transfusion in non-endemic regions, generally due to immigration processes from endemic areas. METHODOLOGY: The objective of this study was to evaluate anti-T. cruzi seroprevalence in blood donors from the western part of São Paulo State, Brazil, by serologic and immunofluorescence confirmation tests for the period between 2012 and 2014. Currently, this region is regarded as a non-endemic area for Chagas disease. RESULTS: The confirmed overall T. cruzi seroprevalence among blood donors was 0.10%, which can be considered low compared to other Brazilian regions. Nevertheless, the distribution of the anti-T. cruzi antibodies within the examined region was uneven, and some areas of significantly higher prevalence were observed. CONCLUSIONS: We could consider two tendencies in the prevalence of T. cruzi: (i) residual older undiagnosed cases from São Paulo State, and (ii) immigration from endemic Brazilian or South American regions. The discordance obtained for T. cruzi prevalence by serologic and immunofluorescence methods demonstrates that more specific routine diagnosis is needed to diminish the cost of the assays and the loss of blood supply once all seropositive blood bags are immediately discarded.

Evaluation of human T-lymphotropic virus prevalence/co-infection rates for a four-year period in a non-metropolitan blood center in Southeast Brazil.

INTRODUCTION: Human T-lymphotropic virus types 1/2 (HTLV-1/2) are distributed worldwide and are endemic in specific regions. METHODS: Serological evaluation of the HTLV-1/2 prevalence and co-infection rate [human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), Chagas disease, and syphilis)] for 2011-2014 was performed with volunteer blood donors from the western part of São Paulo State. RESULTS: Serrana and Araçatuba had higher HTLV seroprevalence rates (0.1%); while Franca, Olimpia, and Bebedouro had lower seroprevalences (0.04%). Co-infection (HBV and syphilis) was present in 12.3% of HTLV-infected blood donors. CONCLUSIONS: Our findings provide data for the prevalence of HTLV in Brazil and demonstrate the importance of regional and global hemovigilance.

HTLV-1/2 seroprevalence and coinfection rate in Brazilian first-time blood donors: an 11-year follow-up.

The seroprevalence and geographic distribution of HTLV-1/2 among blood donors are extremely important to transfusion services. We evaluated the seroprevalence of HTLV-1/2 infection among first-time blood donor candidates in Ribeirão Preto city and region. From January 2000 to December 2010, 1,038,489 blood donations were obtained and 301,470 were first-time blood donations. All samples were screened with serological tests for HTLV-1/2 using enzyme immunoassay (EIA). In addition, the frequency of coinfection with hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), Chagas disease (CD) and syphilis was also determined. In-house PCR was used as confirmatory test for HTLV-1/2. A total of 296 (0.1%) first-time donors were serologically reactive for HTLV-1/2. Confirmatory PCR of 63 samples showed that 28 were HTLV-1 positive, 13 HTLV-2 positive, 19 negative and three indeterminate. Regarding HTLV coinfection rates, the most prevalent was with HBV (51.3%) and HCV (35.9%), but coinfection with HIV, CD and syphilis was also detected. The real number of HTLV-infected individual and coinfection rate in the population is underestimated and epidemiological studies like ours are very informative.

HTLV-1/2 seroprevalence and coinfection rate in Brazilian first-time blood donors: an 11-year follow-up / Soroprevalência e taxa de coinfecção do HTLV-1/2 em doadores de sangue de primeira vez brasileiros: 11 anos de estudo

The seroprevalence and geographic distribution of HTLV-1/2 among blood donors are extremely important to transfusion services. We evaluated the seroprevalence of HTLV-1/2 infection among first-time blood donor candidates in Ribeirão Preto city and region. From January 2000 to December 2010, 1,038,489 blood donations were obtained and 301,470 were first-time blood donations. All samples were screened with serological tests for HTLV-1/2 using enzyme immunoassay (EIA). In addition, the frequency of coinfection with hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), Chagas disease (CD) and syphilis was also determined. In-house PCR was used as confirmatory test for HTLV-1/2. A total of 296 (0.1%) first-time donors were serologically reactive for HTLV-1/2. Confirmatory PCR of 63 samples showed that 28 were HTLV-1 positive, 13 HTLV-2 positive, 19 negative and three indeterminate. Regarding HTLV coinfection rates, the most prevalent was with HBV (51.3%) and HCV (35.9%), but coinfection with HIV, CD and syphilis was also detected. The real number of HTLV-infected individual and coinfection rate in the population is underestimated and epidemiological studies like ours are very informative.

A soroprevalência e a distribuição geográfica do HTLV-1/2 entre os doadores de sangue são extremamente importantes para os serviços de transfusão. Neste trabalho, foi determinada a soroprevalência da infecção pelo HTLV-1/2 entre os doadores de sangue de primeira vez da cidade de Ribeirão Preto e região. No período de Janeiro de 2000 a Dezembro de 2010, 1.038.489 doações de sangue foram obtidas sendo 301.470 doações de primeira vez. Todas as amostras foram avaliadas com testes sorológicos para HTLV-1/2 usando ensaio imunoenzimático (EIA). Adicionalmente, a frequência de coinfecção com o vírus da hepatite B (HBV), vírus da hepatite C (HCV), vírus da imunodeficiência humana (HIV), doença de Chagas (CD) e sífilis também foi determinada. Adicionalmente, foi utilizada uma reação de PCR in-house como teste confirmatório para HTLV-1/2. Um total de 296 (0,1%) doadores de primeira vez foram sorologicamente reativos para HTLV-1/2. O PCR confirmatório de 63 amostras mostrou que 28 eram HTLV-1 positivas, 13 HTLV-2 positivas, 19 negativas e três indeterminadas. Em relação às taxas de coinfecção com HTLV1/2, a maior prevalência foi com HBV (51,3%) e HCV (35,9%), mas a coinfecção com HIV, CD e sífilis também foram detectadas. O número real de indivíduos infectados pelo HTLV-1 e a taxa de coinfecção na população é subestimado e estudos epidemiológicos como esse são muito informativos.