HIV acute infection and long-term undisclosed HIV status among blood donors from the highly endemic Amazonas state, located in the Brazilian Amazon.

BACKGROUND: The Amazonas state/AM and Manaus rank among the highest AIDS detection rates in Brazil. High proportion of HIV infected blood donors and transmission clusters of multidrug antiretroviral/ARV resistant viruses were described in HEMOAM blood donors, a main Amazonas public blood bank. Recent and long-term infections among previously genotyped donors are reported. METHODS/MATERIALS: The recency immunoassay Lag Avidity EIA (Maxim, USA) was employed. Clinical/CD4/viral load medical file data of the main local HIV management center (FMT-HVD) and ARV treatment/ART data were reviewed. RESULTS: Among 142 HIV-blood donors, chronic infection predominated (n = 87; 61.3 %), 79 based on LAg EIA and 8 undisclosed HIV identified in FMT-HVD records, mostly young adult, single males, 4 repeat donors, all ART-naive. Recent infections represented 30.3 % (n = 43), 39 identified by LAg EIA and 4 immunologic windows (antibody negative/NAT/RNA positive). The overall profile of recent and long-term infections was similar, including moderate rate of transmitted drug resistance/TDR, however with multiple resistance mutations to more than one ARV-class, suggesting ART/failure. DISCUSSION: Recent/acute and undisclosed/long-term HIV infections represent blood safety alerts suggesting test-seeking behavior of at-risk populations. Early ART use in Brazil, can turn HIV diagnosis more challenging representing a blood transfusion risk in the highly endemic Brazilian Amazon.

[The Metabolic syndrome and metabolic characteristics in blood donors] / El Síndrome metabólico y características metabólicas en donantes de sangre.

Introduction: Metabolic syndrome (MS) is associated with increased cardiovascular risk. Blood donors are an apparently healthy population in which certain cardiometabolic characteristics are not evaluated in their selection, and there is limited information on their presence. Aim: To determine the frequency of metabolic syndrome and its metabolic characteristics in blood donors. Materials and methods: Cross-sectional study was carried in a population of 244 blood donors between 18 and 55 years of age who attended the Hemotherapy and Blood Bank Service of the Cayetano Heredia Hospital in Lima, Perú during the month of May 2023. The diagnosis of MS was made according to the Adult Treatment Panel III (ATP III) criteria. A bivariate analysis was performed between MS and metabolic characteristics with sex and a significance level of 5% was considered. Results: 63.9% of blood donors were male. 43.6% of the population had MS. The most frequent characteristics found were hypertriglyceridemia (54.5%), abdominal obesity (51.2%) and high-density lipoprotein (HDL) low (48.8%). The age range of 40 to 49 years presented the highest frequency of MS (14.3%). Hypertriglyceridemia and high blood pressure were associated with male sex (p=0.003 and p=0.019 respectively), while low HDL was associated with female sex (p<0.001). Conclusions: Blood donors present an elevated frequency of MS. The detection of MS in apparently healthy populations as part of primary care could allow the formulation of strategies for early detection of cardiovascular risk factors.

INTRODUCCIÓN: El síndrome metabólico (SM) está asociado a un incremento del riesgo cardiovascular. Los donantes de sangre son una población aparentemente sana en donde ciertas características cardiometabolicas no son evaluadas en su selección, existiendo limitada información sobre su presencia. OBJETIVO: Determinar la frecuencia de síndrome metabólico y sus características metabólicas en donantes de sangre. Materiales y métodos: Estudio transversal realizado en 244 donantes de sangre entre 18 y 55 años que acudieron al Servicio de Hemoterapia y Banco de sangre del Hospital Cayetano Heredia en Lima- Perú, durante el mes de mayo del 2023. Se realizó el diagnóstico de SM según los criterios del Adult Treatment Panel III (ATP III). Se realizó un análisis bivariado entre el SM y características metabólicas con el sexo y se consideró un nivel de significancia del 5%. RESULTADOS: El 63.9% de los donantes de sangre fueron del sexo masculino. El 43.6 % de la población presentó SM. Las características más frecuentes fueron la hipertrigliceridemia (54.5%), obesidad abdominal (51.2%) y lipoproteina de alta densidad (HDL) bajo (48.8%). El rango de edad de 40 a 49 años presentó la mayor frecuencia de SM (14.3%). La hipertrigliceridemia y presión arterial elevada estuvieron asociadas al sexo masculino (p=0.003 y p=0.019 respectivamente), mientras que el HDL bajo al sexo femenino (p <0.001). CONCLUSIONES: Los donantes de sangre presentan una frecuencia elevada de SM. La detección de SM en poblaciones aparentemente sanas como parte de la atención primaria podría permitir formular estrategias de detección temprana de factores de riesgo cardiovascular.

High prevalence of dengue, Zika, and chikungunya viruses in blood donors during a dengue outbreak and an endemic period in Colombia.

Objective: Arboviruses pose a challenge in ensuring the supply of pathogen-free blood components because they are not routinely screened in blood banks, and blood components from infected asymptomatic donors could be transfused. This study aimed to detect and characterize arboviral infections in Colombian blood donors. Methods: In a cross-sectional study, the prevalence of dengue (DENV), Zika (ZIKV), and chikungunya (CHIKV) viruses and co-infections of blood donors were compared between an epidemic period (November 2019-February 2020, n = 462) and an endemic period (November 2021-August 2022, n = 1,119). Viral RNA from each donor serum was purified, and the viruses were detected using a previously standardized multiplex hemi-nested RT-PCR protocol. Subsequently, donors who tested positive were surveyed 15 days after the detection of the virus to identify clinical characteristics related to the arboviral infection. The prevalences of each virus were presented as percentages and compared between epidemic and endemic periods. Results: Significantly higher prevalences were found in the epidemic period compared with the endemic period for DENV (14.5 vs. 1.9%), ZIKV (7.8 vs. 0.3%), CHIKV (8 vs. 3.3%), and co-infections (4.3 vs. 0.2%). The survey response rate of positive donors in the two periods was 83/175 (47%). In total, 57% of the donors surveyed were asymptomatic. Symptomatic donors most frequently reported headache (31%), malaise (13%), arthralgia (10%), and fever/chills (8%). Conclusion: The prevalence observed in epidemic and endemic periods was higher than that reported in other studies in the Americas. The high proportion of asymptomatic cases found, in addition to the mild and nonspecific manifestations among the symptomatic, may limit the effectiveness of the donor selection criteria used to mitigate the risk of transfusion-transmitted arboviruses.

Finger photopletysmography detects early acute blood loss in compensated blood donors: a pilot study.

Objective.Diagnosis of incipient acute hypovolemia is challenging as vital signs are typically normal and patients remain asymptomatic at early stages. The early identification of this entity would affect patients' outcome if physicians were able to treat it precociously. Thus, the development of a noninvasive, continuous bedside monitoring tool to detect occult hypovolemia before patients become hemodynamically unstable is clinically relevant. We hypothesize that pulse oximeter's alternant (AC) and continuous (DC) components of the infrared light are sensitive to acute and small changes in patient's volemia. We aimed to test this hypothesis in a cohort of healthy blood donors as a model of slight hypovolemia.Approach.We planned to prospectively study blood donor volunteers removing 450 ml of blood in supine position. Noninvasive arterial blood pressure, heart rate, and finger pulse oximetry were recorded. Data was analyzed before donation, after donation and during blood auto-transfusion generated by the passive leg-rising (PLR) maneuver.Main results.Sixty-six volunteers (44% women) accomplished the protocol successfully. No clinical symptoms of hypovolemia, arterial hypotension (systolic pressure < 90 mmHg), brady-tachycardia (heart rate <60 and >100 beats-per-minute) or hypoxemia (SpO2< 90%) were observed during donation. The AC signal before donation (median 0.21 and interquartile range 0.17 a.u.) increased after donation [0.26(0.19) a.u;p< 0.001]. The DC signal before donation [94.05(3.63) a.u] increased after blood extraction [94.65(3.49) a.u;p< 0.001]. When the legs' blood was auto-transfused during the PLR, the AC [0.21(0.13) a.u.;p= 0.54] and the DC [94.25(3.94) a.u.;p= 0.19] returned to pre-donation levels.Significance.The AC and DC components of finger pulse oximetry changed during blood donation in asymptomatic volunteers. The continuous monitoring of these signals could be helpful in detecting occult acute hypovolemia. New pulse oximeters should be developed combining the AC/DC signals with a functional hemodynamic monitoring of fluid responsiveness to define which patient needs fluid administration.

Comparative evaluation of rapid plasma reagin and ELISA with Treponema pallidum hemagglutination assay for the detection of syphilis in blood donors: a single center experience.

INTRODUCTION: The prime responsibility of blood transfusion services in India is to provide safe blood. The donated blood is tested for human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), malaria and syphilis. In India, the screening of donated blood for syphilis is performed by rapid plasma reagin (RPR) or venereal disease research laboratory (VDRL), whereas the World Health Organization (WHO) recommends screening of syphilis in blood donors by enzyme-linked immunosorbent assay (ELISA). Therefore, the aim of this study was to evaluate the performance of RPR and ELISA with the Treponema pallidum hemagglutination assay (TPHA - the gold standard) for the detection of syphilis in blood donors. METHODS: In this cross-sectional study, 1524 consecutive whole blood donors were screened from April to October 2022. All blood samples collected during the study period were tested by RPR, ELISA and the TPHA and the results obtained were compared. RESULTS: The seroprevalence of syphilis in blood donors in this study was 0.06% by RPR and 0.72% by ELISA and TPHA. On considering ELISA and the TPHA as the gold standard, ELISA had comparable sensitivity (100%), a higher specificity (100% vs. 99.34%), a higher positive predictive value (PPV - 100% vs. 9.1%) and no biological false positive/false negative results (0 vs. 10 false negatives) when compared to RPR. CONCLUSION: ELISA performed better as a screening assay than RPR in the detection of syphilis in blood donors, which is in agreement with the WHO recommendations for syphilis testing in blood donors with low prevalence.

Breakthrough infection by hepatitis B virus in a vaccinated blood donor: An emerging threat for transfusion safety in low-endemic countries?

We present the case of a breakthrough infection by hepatitis B virus (HBV), intending to warn about the challenge that HBV represents for transfusion safety. Virological markers for HBV infection were assayed during a blood donor screening by detection of HBsAg, anti-HBc, and viral nucleic acid (HBV DNA) by a nucleic acid test (NAT). Additionally, samples were analyzed for detection of immunoglobulin M anti-HBc, HBeAg, anti-HBe, and anti-HBs. A first-time donor repeatedly tested positive for HBV DNA by NAT and nonreactive for HBV-serological markers of infection. He stated having completed the anti-HBV vaccination schedule; thus, study of anti-Hbs resulted in reactive at protective level (18 mIU/mL). The donor denied clinical symptoms of hepatitis and remained healthy during the follow-up period. 95 days postdonation, NAT was negative, seroconversion of anti-HBc ab was detected, and a significant increase in anti-HBs concentration was measured (>1000 mIU/mL). This is the first case of HBV-breakthrough infection reported in Argentina and to our knowledge, this potential threat to transfusion safety is novel in an HBV low-endemic region with high coverage of HBV vaccination. The occurrence of breakthrough infections challenges the current protocols for the identification of HBV-infected subjects, could be a source of silent HBV transmission.

In situ and in vitro evaluation of two antiseptics for blood bank based on chlorhexidine gluconate/isopropyl alcohol and povidone-iodine.

BACKGROUND: Poor disinfection is the main cause of blood contamination, so its elimination is key to limiting the entry of bacteria into the collection system. With the advancement of antiseptic technology, antiseptics with sterile, disposable applicators are now available. AIM: To evaluate in situ two antiseptics (with and without applicators) for blood banks and to demonstrate in vitro antiseptic activity on bacterial biofilms of importance in transfusion medicine. METHODS: Antiseptic A (2% sterile solution of chlorhexidine gluconate/70% isopropyl alcohol provided with applicator) and bulk antiseptic B (10% povidone-iodine) were evaluated. The deferred blood donor arms were subjected to disinfection with antiseptics A and B and the contralateral arms were cultured to determine the baseline bacterial load (control). Antiseptic activity was assessed by ANOVA and logaritmic reduction values (LRV) and percentage reduction values (PRV) were calculated. Finally, the in vitro activity of antiseptic A was analyzed by confocal laser scanning microscopy (CLSM) on biofilm models. RESULTS: Prior to disinfection tests, commensal and clinically important bacteria were identified; antiseptic A showed post-disinfection bacterial growth rates of zero compared to controls (p < 0.0001). The frequency of bacterial growth with antiseptic B was 74%. A significant difference was identified between both antiseptics, where antiseptic A showed higher activity (p < 0.5468). LRV and PRV were 0.6-2.5/100% and 0.3-1.7/66.7-99.7% for antiseptics A and B, respectively. Through CLSM, disinfectant A (without applicator) showed lower in vitro antiseptic activity on the tested biofilms at the exposure times recommended by the manufacturer. CONCLUSIONS: Sterile solution of chlorhexidine gluconate/isopropyl alcohol with applicator showed advantages disinfection in deferred blood donors over povidone-iodine.

Seroepidemiology of Toxoplasma gondii infection in blood donors in a population from the northwestern region of São Paulo state, Brazil.

BACKGROUND: Toxoplasmosis is one of the most common parasitic infections worldwide with varying prevalence between human populations. These variations are mainly associated with human exposure to risk factors. In this article, the seroprevalence of Toxoplasma gondii infection and the risk factors associated with infection in 1729 blood donors from São José do Rio Preto, São Paulo, Brazil were analysed. METHODS: The serological tests for detecting immunoglobulin M (IgM) and immunoglobulin G (IgG) anti-T. gondii were used. The risk factors associated with the infection were identified through the application of an epidemiological questionnaire. RESULTS: The prevalence of T. gondii infection was 48.0%. The following factors were identified in the final model after multiple logistic regression analysis: drinking raw milk (p=0.003; odds ratio [OR] 1.364 [confidence interval {CI} 1.1 to 1.7]), residing in a rural area (p<0.0001; OR 2.764 [CI 1.7 to 4.6]) and receiving a blood transfusion (p=0.015; OR 1.856 [CI 1.1 to 3.0]). CONCLUSIONS: The data obtained in this study showed that the blood donor population is exposed to risk factors related to infection by T. gondii. These data allow the establishment of control programs to contribute to public health in northwestern São Paulo state.

External quality control program in infectious diseases screening at laboratories and blood banks in Latin America: an analysis of the past 5 years.

Objective: To evaluate the screening of blood samples for infectious disease markers at laboratories and blood banks in Latin America per the findings of an External Quality Assessment Program (EQAP). Methods: This qualitative analysis used data from the EQAP coordinated by the Fundação Pro Sangue Hemocentro de São Paulo with the support of the Pan American Health Organization to assess the performance of blood screening for infectious diseases from 2014 to 2018 in Latin America. Each participating laboratory or blood bank received an identical blind panel with 24 blood samples with variable reactivity for all the screening parameters. Panels were processed at each participating facility and results were returned to the Fundação Pro Sangue Hemocentro de São Paulo for individual and joint analyses. Two types of discrepant results were potential failures: false positive results (FPRs) and false nonreactive results (FNRRs). Results: A total of 23 136 samples were evaluated. Global rates of FPR, FNRR, and concordant results were 0.3%, 1.0% and 98.7%, respectively. Seven FNRRs were found for HBsAg (1.0%), 12 for syphilis (2.6%), and 21 for Chagas disease (2.9%). No FNRRs were found for the HIV, HCV, and HTLV viruses. The average accuracy of all the laboratories and blood banks participating in the EQAP during the study period was 99.5% (standard deviation, 0.5%). Conclusion: The findings of this qualitative analysis are positive for blood safety in Latin America, with an average accuracy of 99.5% among the participating laboratories and blood banks. This report reflects an important improvement in blood bank serological screening EQAP-PAHO report since the 2003.

Rechazo de donantes de sangre en un hospital peruano durante la pandemia de la covid-19 / Rejection of blood donors in a Peruvian hospital during the COVID-19 pandemic i: en

Introducción: El SARS-CoV-2 ha tenido un impacto negativo y significativo en los sistemas de salud a nivel mundial, lo cual además amenazó el suministro de sangre necesario para las transfusiones clínicas. Objetivo: Describir las causas del rechazo de donantes de sangre durante la pandemia de covid-19. Métodos: Se realizó un estudio observacional, transversal y retrospectivo en una población de donantes que acudió al Banco de Sangre del Hospital Nacional Ramiro Prialé Prialé, de Huancayo, en Perú, de julio del 2020 a igual mes del 2022. Las variables analizadas fueron sexo, grupo sanguíneo ABO, factor Rh y tipos y causas de rechazo. Resultados: Del total de 10 177 donantes de sangre, fueron diferidos y excluidos 3390 (33,3 %); la causa más frecuente de diferimiento fue el hematocrito bajo (18,0 %) y la de exclusión, la positividad por el anticuerpo del núcleo de la hepatitis B (36,8 %). Asimismo, predominó el sexo masculino entre los que fueron rechazados (55,2 %) y se evidenció un incremento de la tendencia politómica en los donantes diferidos (R²=0,2214) y excluidos (R²=0,1178). Conclusiones: La prevalencia de diferimiento y exclusión de donantes de sangre hallada en esta serie fue relativamente alta en comparación con la registrada en otros estudios, lo cual se debió principalmente, en cada caso respectivo, al hematocrito bajo y a la presencia del anticuerpo del núcleo de la hepatitis B.

Introduction: SARS-CoV-2 has had a negative and significant impact on global health systems, threatening the necessary blood supply for clinical transfusions. Objective: To describe the causes of rejection of blood donors during the COVID-19 pandemic. Methods: An observational, cross-sectional and retrospective study was carried out in a population of donors who attended the Blood Bank of Ramiro Prialé Prialé National Hospital, in Huancayo, Peru, from July, 2020 to the same month, 2022. The analyzed variables were sex, the ABO blood group, Rh factor and types and causes of rejection. Results: Of total of 10 177 blood donors, 3390 (33.3%) were differed and excluded; the most frequent cause of differing was the low hematocrit (18.0%) and the most frequent cause of exclusion was antibody to hepatitis B core antigen positivity (36.8%). Likewise, male sex predominated among those who were rejected (55.2%) and an increment of the polytomous tendency was evidenced in differed (R²=0.2214) and excluded donors (R²=0.1178). Conclusions: The prevalence of differing and exclusion in blood donors was relatively high compared to that reported in other studies, which was mainly due, in each respective case, to the low hematocrit and the presence of antibody to hepatitis B core antigen.

Correlation of serological and molecular markers in the screening for hepatitis B virus in blood bank in northern Brazil

ABSTRACT Introduction: In Brazil, the blood donor screening for hepatitis B virus (HBV) includes laboratory testing for serological (HBsAg and Anti-HBc) and molecular (HBV DNA) markers. This study aims to correlate serology reactive results with HBV DNA detection among blood donors with at least one HBV infection marker detected in a blood bank in northern Brazil. Method: A retrospective search for HBV reactive blood donor data from January 2017 to December 2019 was performed. Serological screening was performed by chemiluminescent microparticle immunoassays Architect HBsAg and Architect Anti-HBc, whereas molecular screening was performed by the HBV nucleic acid test (HBV NAT). Main results: A total of 556 HBsAg reactive results were detected, between positive (47.66%) and inconclusive (52.34%). A total of 3,658 Anti-HBc reactive results were detected, between positive (83.71%) and inconclusive (16.29%). None of the inconclusive results were associated with HBV DNA detection. The HBV DNA detection rates were 47.55% among HBsAg positive samples and 4.08% among Anti-HBc positive samples. The signal-to-cutoff (S/CO) ratio median of HBV NAT positive samples was superior in comparison to HBV NAT negative samples (p < 0.0001). The thresholds found to optimize sensitivity and specificity were 404.15 for Architect HBsAg and 7.77 for Architect Anti-HBc. Three blood donors were in the window period and 1 occult HBV infection case was detected. Conclusion: High S/CO ratios were more predictive of HBV DNA detection. However, a number of HBV NAT positive samples gave low values, while some HBV NAT negative samples showed high values, reaffirming the significance of molecular testing to enhance transfusion safety.

A survey on insight of blood donors during COVID pandemic in Southern India

ABSTRACT Introduction: Knowledge, Attitude and Practices (KAP) surveys prove beneficial to the transfusion services by providing an insight into the donors and, thus, aiding in mobilizing and retaining voluntary blood donors. We aim to study the knowledge, attitude and practices of donors towards blood donation in a pandemic setting. Methods: A cross-sectional observational study to assess the knowledge, attitude and practices of blood donors was conducted between June to and October 2020. Non-parametric tests (Mann - Whitney U and Kruskal - Wallis) were performed to evaluate the relation of knowledge, attitude and practices overall scores with age group, gender and history of blood donations (first us. repeat). The Chi-Square test/Fisher's Exact test was used to evaluate the differences in the distribution of Knowledge, Attitude and Practices items within the groups. Results: A total of 403 of 2,748 individuals who came for whole blood donation participated in the study. The mean age of the study population was 31.1years (SD ± 8.4 range: 18 - 58), with 75% of the donors donating for the first time. The fear of acquiring COVID-19 infection was perceived as a major reason for the eligible population not to donate. The overall knowledge, attitude and practice score among the donors was satisfactory, being 76.14%, with a significant association with age. The overall positive attitude and practices scores of blood donors were 85.48% and 78.04%, respectively. Conclusion: The KAP scores were satisfactory among the donors. Timely communication of the precautionary measures at blood centers to contain the spread of the COVID-19 infection and effective counseling would help in motivating and retaining blood donors.

Seroprevalence of viral transfusion transmissible infections (HBsAg, anti-HCV, anti-HIV, Syphilis) and coinfection among healthy volunteer blood donors during 5-years in Luanda, Angola.

BACKGROUND: The transmission of diseases by blood products continues to be a worldwide health problem, especially in Africa. Seroprevalence rates of the Hepatitis B virus (HBV), Hepatitis C virus (HCV), Human Immunodeficiency Virus (HIV), Syphilis, and Coinfection in Angola are poorly documented. This study aims to identify the seroprevalence of markers with positive results for Hepatitis B, C, HIV, Syphilis, and Coinfection in blood donors. MATERIAL AND METHODS: A retrospective study was conducted using a database of positive serological markers for these infections and coinfection in 2734 blood donors traced from 2011 to 2016 in Luanda, Angola. The Chi-Square test (χ2) or Fisher's exact test was used to evaluate serological positivity and donors' characteristics. A p-value < 0.05 was considered statistically significant. RESULTS: 2734 blood donors aged 18 to 64 (median age 32 ± 9) were screened from 2011 to 2016. 73.9 % of the donors were positive for one Transfusion-Transmitted Infection (TTI), and 5.9 % showed evidence of multiple infections. The overall seroprevalence rate was 50.2 % (1373) for HBV, 20 % (436) for Syphilis, 7 % (191) for HIV, 5.1 % (140) for HCV, and 5.8 % for coinfected donors. 2467 (90 %) were men, and 267 (10 %) were women. We identified 118 (5.8 %) coinfected donors. Of those, 40 (33.9 %) simultaneously presented Hepatitis B virus surface antigen (HBsAg)/Syphilis, 24 (20.3 %) HBsAg/HIV, 22 (18.6 %) HBsAg/HCV, 20 (16.9 %) HIV/Syphilis, 8 (6.8 %) HCV/Syphilis, and 4 (3.4 %) HIV/HCV. CONCLUSION: A high transfusion-transmissible infection prevalence was found compared to some countries in Sub-Saharan Africa. Therefore, intensifying the screening for these transfusion-transmitted infections in blood donors is critical to ensure blood safety.

Barriers and motivations for blood donation: an integrative review.

INTRODUCTION: It has been estimated that the proportion of blood donors in Brazil is below 2.0 %, lower than that recommended by the World Health Organization, which is between 3 % and 5 % of the population. OBJECTIVE: The aim of this study was to analyze the factors that can influence blood donation. METHOD: This is an integrative review, whose bibliographic search was carried out through the Virtual Health Library, considering scientific articles indexed in the Latin American and Caribbean Literature in the Health Sciences database. RESULTS: This process was performed in July 2022 with term "blood donors" and 901 publications were identified, without delimitation of the study period or any other aspects. After applying the inclusion and exclusion criteria, 40 articles were fully reviewed. The studies were categorized according to the main content discussed in "characteristics and perspectives of donors", "perspective of health professionals and services" and "loyalty strategies: marketing and communication in health". Access to coherent information about the donation process was the motivational aspect evidenced in the three categories of analysis, that is, indispensable from the perspective of users, health professionals who work in blood therapy services and for marketing and communication in health. It is through the knowledge of the procedure that uncertainties and fear are decreased and loyal donors are increased. CONCLUSION: Altruism was the most frequent driving feeling in the consulted literature, whereas the lack of time and fear were the routine obstacles. The campaigns were identified as communication and health education actions relevant to attracting and retaining the donor, as well as applications and social networks.

Doação de sangue durante a pandemia da Covid-19: conhecimentos, práticas e atitudes dos estudantes de medicina / Blood donation during the Covid-19 pandemic: knowledge, practices and attitudes of medical students

Doação voluntária de sangue é um ato desafiador, em especial, durante períodos de crise sanitária. O propósito deste estudo transversal foi analisar os conhecimentos, práticas e atitudes dos estudantes de medicina, do ciclo básico ao internato, quanto à doação de sangue durante a pandemia da Covid-19. O trabalho foi realizado entre maio e dezembro de 2021, via Google forms. Para motivo de comparação, a amostra (n=327) foi dividida em do-adores (n=183) e não doadores (n=144) de sangue e utilizado teste qui-quadrado e teste exato de Fisher, sendo considerado estatisticamente significantes perguntas que obtiveram valores com p<0,05. Os resultados indicam que, mesmo sendo a minoria de ambos os grupos, ainda há uma quantidade significativa de estudantes de medicina que apresentam pouco domínio sobre o processo de doação de sangue, além de estarem permeados por medo e desinformação sobre a segurança da coleta. Fatos estes, ainda mais perceptíveis durante o período da pandemia, no qual o percentual de doadores foi de 30,6%. Desta forma, ressalta-se a necessidade de estratégias educacionais criativas e contextualizadas para esclarecer e sensibilizar melhor os jovens para este ato de solidariedade (AU).

Voluntary blood donation is a challenging act, especially during a health crisis. The purpose of this cross-sectional study was to analyze the knowledge, practices, and attitudes of medical students, from the basic cycle to the internship, regarding blood donation during the Covid-19 pandemic. The work was carried out between May and December 2021 via Google Forms. For comparison, the sample (n=327) was divided into blood donors (n=183) and non-donors (n=144). The chi-square and Fisher's exact tests were used, considering statistically significant questions with p<0.05 p-value. The results indicate that, even though they are a minority of both groups, there is still a significant number of medical students who do not know much about the blood donation process and are permeated by fear and misinformation about blood collection safety. These facts were even more noticeable during the pandemic, in which the percentage of donors was 30.6%. In this way, the need for creative and contextualized educational strategies is highlighted to clarify and better sensitize young people to this act of solidarity (AU).

Standardization of a multiplex assay to identify weak D types in a mixed-race Brazilian population.

RH allele variability is caused by several types of variants, resulting in altered RhD and RhCE phenotypes. Most of the weak D phenotypes in European-derived populations are weak D types 1, 2, or 3, which are not involved in alloimmunization episodes. However, the Brazilian population is racially diverse, and the accuracy of molecular and serologic tests developed in recent years has allowed for the identification of other RH variants, that are common in the Brazilian population, such as weak D type 38 or weak partial 11, the latter involved in alloimmunization cases. Furthermore, patients with these two weak D variants must be transfused with D- red blood cell units, as do patients with weak D type 4 or DAR, which are also common D variants in Brazil. Weak D type 38 and weak partial 11 can be serologically misclassified as weak D types 1, 2, or 3 in patients, based on European experience, or as D- in donors. Additionally, pregnant women may unnecessarily be identified as requiring Rh immune globulin. RhCE phenotypes are reliable indicators of RhD variants. For individuals with the Dce phenotype, the preferred approach is to specifically search for RHD*DAR. However, when encountering DCe or DcE phenotypes, we currently lack a developed method that assists us in rapidly identifying and determining the appropriate course of action for the patient or pregnant woman. Two multiplex assays were proposed: one for the identification of RHD*weak partial 11, RHD*weak D type 38, and RHD*weak D type 3 and another for RHD*weak D type 2 and RHD*weak D type 5. The multiplex assays were considered valid if the obtained results were equivalent to those obtained from sequencing. Expected results were obtained for all tested samples. The proposed multiplex allele-specific polymerase chain reaction assays can be used in the molecular investigation of women of childbearing age, patients, and blood donors presenting a weak D phenotype with DCe or DcE haplotypes in a mixed-race population, such as Brazil.

Detection of unreported usage of the antiretroviral drug lamivudine in two blood donors.

BACKGROUND: Unreported HIV antiretroviral (ARV) drug usage by blood donors compromises the ability to detect evidence of HIV infection in blood screening tests and represents a risk for blood transfusion safety. Our objective was to determine the frequency of undeclared ARV drug use by blood donors with altered HIV markers. STUDY DESIGN AND METHODS: This was a retrospective cross-sectional analysis of donations that were tested for HIV antibody (ab), antigen (ag), and RNA by chemiluminescent immunoassay and nucleic acid screening tests. Positive samples were retested and were subjected to ARV drug testing by high-performance liquid chromatography-tandem mass spectrometry. RESULTS: Of 345,252 blood donations, 361 (0.1%) were positive on initial testing. Samples from 296 (81.9%) of these donations were available for further analysis. The presence of HIV ab/ag and/or RNA was confirmed in 83 (28.0%) of these samples. All 296 bloods were subjected to ARV testing. The ARV drug lamivudine, at 11.3 and 6.7 ng/mL, was detected in 2 of 83 (2.4%) donations that were HIV positive. Other drugs were not detected. CONCLUSION: Unreported ARV usage was identified in two candidates for blood donation. More intensive efforts to educate donors about disclosure and to investigate the extent of this phenomenon in Brazil are needed.

Frequencies of genetic variants of the Rh, Kell, Duffy, Kidd, MNS and Diego systems of northwest Rio Grande do Sul, Brazil

ABSTRACT Introduction: To date, 340 antigen-organized 43 blood group systems are recognized, being ABO, Rh, Kell, Duffy, Kidd, MNS and Diego the most clinically relevant. The aim of this study was to assess the distribution of alleles and genotypes of the blood group systems Rh, Kell, Duffy, Kidd, MNS and Diego in 810 blood donors registered in the hemotherapy unit in northwest Rio Grande do Sul, Brazil Methods: We evaluated the genetic variability of blood groups Rh (c.676G>C and c.307C>T), Kell (c.578C>T), Kidd (c.838A>G), Duffy (c.125A>G and c.l-67T>C), Diego (c.2561C>T) and MNS (c.143T>C) in 810 volunteer blood donors of Rio Grande do Sul, southern Brazil. The genetic profiling was performed through allelic discrimination assays using hydrolysis probes (TaqMan®) real-time PCR system. Results: The most frequent blood group genotypes found in our study population were: RHC*Cc (51.5%), RHC*ee (70.1%), FY*A/FY*B (49.3%), GATA -67T/T (93.5%), KEL*2/KEL*2 (93.4%), Jk*A/JK*B (53.2%) and DI*02/DI*02 (95.4%). Some statistical differences were observed on comparing the population of this study with populations from other states in Brazil, mainly with population of Minas Gerais, Bahia and Paraná, which showed some differences from the population of Porto Alegre, which was more similar to those of Santa Catarina and São Paulo Conclusion: The frequency of red blood cell polymorphisms in our study is different from that of blood donors in other regions of Brazil. The results showed the importance of extended genotyping in adequate blood screening and the existence of rare genotypes in Brazilian regular blood donors

Human T-lymphotropic virus 2 (HTLV-2) prevalence of blood donors in the state of Pará, Brazil.

INTRODUCTION: The present study had the objective to describe the molecular prevalence and epidemiological aspects of the human T-lymphotropic virus 2 (HTLV-2) infection in the blood donor population of the Pará state. METHODS: The present study is a descriptive, retrospective, and cross-sectional review of epidemiological, serological, and molecular data on inapt blood donors in the State Center for Hematology and Hemotherapy from January 2015 to December 2021. The data were digitalized to create a database using the Statistical Package for Social Sciences program. The prevalence of HTLV-2 was calculated based on the total number of donations during the study period. Descriptive frequency was used to analyze the qualitative data. RESULTS: A total of 665,568 blood donations were made. Out of these, 1884 (0.2%) samples presented serological detection to HTLV and further were evaluated using molecular confirmatory tests. Out of these, 36 samples were positive for HTLV-2 using qPCR Taqman assay based on pol gene region (0.005%). The HTLV-2 was found to be more prevalent in women (63.9%); aged between 39 and 59 years (55.6%); residents of the metropolitan region of Belém (80.6%); with self-declared race as brown (80.6%); individuals who had completed high school (58.6%); and first-time donors (58.3%) CONCLUSION: The present study identified the presence of HTLV-2 (1 HTLV-2 case/20,000 donations; 0.005%) in the specific population of blood donors in Pará state. These findings can contribute to the existing literature on the subject both for specific population groups under study and for understanding the prevalence of HTLV-2 in the general population.