Document 0370
 DOCN  M9440370
 TI    Potential deferral criteria predictive of human immunodeficiency virus
       positivity among blood donors in Thailand.
 DT    9404
 AU    Kitayaporn D; Bejrachandra S; Chongkolwatana V; Chandanayingyong D;
       Weniger BG; HIV/AIDS Collaboration, Nonthaburi, Thailand.
 SO    Transfusion. 1994 Feb;34(2):152-7. Unique Identifier : AIDSLINE
       MED/94143945
 AB    BACKGROUND: To develop deferral criteria to prevent human
       immunodeficiency virus (HIV) transmission by recently infected blood
       donors in the seronegative window phase, routine data on donors at a
       university hospital were examined for factors predicting seropositivity.
       STUDY DESIGN AND METHODS: Records of all 281 HIV-positive blood donors
       from August 1987 through September 1991 were retrospectively compared
       with those of 1076 randomly selected control donors matched only by year
       of donation. Four controls were selected for each HIV-positive donor.
       RESULTS: The prevalence of HIV in 102,684 donor units during the period
       rose from 0.02 percent in 1987 to 0.52 percent in 1991. Multivariable
       analysis revealed that male sex (odds ratio [OR] = 26.4), VDRL test
       positivity (OR = 3.0), age 21 to 30 years (OR = 2.2; referent:
       16-20-year-old group), and replacement donorship (OR = 1.4; referent:
       voluntary donors) were independent factors significantly associated with
       HIV positivity among these donors (p < 0.05). Since replacement
       donorship cannot be avoided, only male sex, age 21 to 30 years, and VDRL
       test positivity were considered as potential criteria. When these
       findings were extrapolated to all donors in 1990 and 1991, those with
       all three or only two (excluding VDRL test, because the results are
       known only after donation) of these high-risk factors had HIV positivity
       probabilities of 2.2 and 1.0 percent, respectively. These probabilities
       were, respectively, 4.9 times (95% CI: 2.9 8.3) and 4.1 times (3.1, 5.4)
       the risk among other donors. However, applying such criteria would have
       eliminated 1.5 and 31.2 percent, respectively, of all HIV-negative
       donors in 1990 and 1991. The latter deferral proportion is too high to
       be acceptable. CONCLUSION: In Thailand, improved donor deferral criteria
       addressing sexual risk factors could lead to decreased probability of
       window-period donation, with an acceptable rate of deferral. Additional
       p24 antigen testing may be indicated for donors at increased risk for
       HIV infection, specifically, men aged 21 to 30.
 DE    Adolescence  Adult  *Blood Donors  Female  Human  HIV
       Infections/*PREVENTION & CONTROL/*TRANSMISSION  *HIV Seropositivity
       Male  Middle Age  Regression Analysis  Retrospective Studies  Risk
       Factors  Syphilis Serodiagnosis  Thailand  JOURNAL ARTICLE

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