Syphilis seroprevalence and incidence in US blood donors from 2020 to 2022

405 nm light microbicidal efficacy on Treponema pallidum spiked in ex vivo human platelets

Pathogen reduction technologies using chemicals and or UV light have been demonstrated to improve the safety of ex vivo platelets from infectious diseases. However, UV light exposure also may affect the treated products, depending on wavelength and exposure. Alternatively, visible spectra 405 nm violet-blue light has broad-spectrum microbicidal activity. Here we tested the effect of 405 nm light on Treponema pallidum, the bacterium that causes syphilis. We contaminated platelets stored in plasma with two treponemal concentrations (low and high titers) and treated an aliquot with 270 J/cm2 dose (irradiance = 15 mW/cm2) of 405 nm light while another aliquot remained untreated. Next, we inoculated intradermally an aliquot of both samples into rabbits. Rabbits inoculated with untreated samples developed syphilis while animals inoculated with light-treated samples did not. Thus, inactivation was demonstrated to the limit of detection of the bioassay. We estimated > 2 log10 and > 4 log10 reduction in the low and high dose studies, respectively. These results provide proof-of-concept that 405 nm light is effective in reducing syphilis risk in ex vivo platelets.

Urban versus rural blood donors in the United States and the relationship with transfusion-transmissible infections

INTRODUCTION

Most US blood donations are from donors living in urban areas. Demographics and infectious disease prevalence may vary in urban versus rural areas. We assessed demographic and transfusion-transmissible infection (TTI) prevalence among donors living in urban versus rural areas.

METHODS

Blood donation data from the Transfusion-Transmissible Infections Monitoring System were categorized as urban or rural based on donor residential zip code for a three-year period (October 2020-September 2023). Demographics and TTI prevalence (HBV, HCV, HIV consensus positive (CP) and recent infection (RI), and syphilis CP and active infection (ASI)) were compared between the two geographies. Regression analysis determined the odds of TTIs among donors while controlling for demographic characteristics.

RESULTS

From 21,941,910 donations, 83.9% were categorized as urban and 16.1% as rural. Donations from urban versus rural donors were more likely to be from men, between the ages of 25 and 54, non-White, and first-time. HBV CP, HIV CP, syphilis CP, and ASI were more prevalent in donations from urban versus rural donors. Significantly higher seroconversion rates also occurred in donors with syphilis CP and ASI. When adjusting for differences in donor demographics and characteristics, only prevalence in HBV CP remained more likely to occur among urban donors (odds ratio (OR): 1.28, 95% CI: 1.03, 1.6) and HCV CP less likely to occur among urban donors (OR: 0.8, 95% CI: 0.71, 0.9).

DISCUSSION

Blood donor demographics and TTI prevalence differ in urban areas compared to rural; however, the differences in demographics may explain some of the TTI prevalence trends.

Increasing syphilis cases in Japan: A risk posed to blood services

BACKGROUND AND OBJECTIVES

Syphilis cases surged in Japan, exceeding 10,000 in 2022, primarily through heterosexual transmission. The Japanese Red Cross Blood Services (JRCBS) screens donated blood for syphilis, disqualifying positive donors. This study explores syphilis infection among blood donors to understand its impact on blood collection and supply.

MATERIALS AND METHODS

Data from blood donors (2015-2022) at JRCBS were analysed. Treponema pallidum (TP) antibody was tested by chemiluminescent enzyme immunoassay or chemiluminescent immunoassay. A total of 39,199,047 donations were scrutinized. Reactive samples were further tested by rapid plasma reagin (RPR).

RESULTS

The number of TP and RPR positives (referred as syphilis positives) in 2022 compared with 2015 increased by 1.7 times in blood donors and 4.9 times in the general population. High syphilis-positive rate in 2022 was mainly observed among male first-time/reactivated donors and females in their 20s and 30s. Although syphilis cases in general population declined during the Corona pandemic, no significant decrease occurred in syphilis-positive donors.

CONCLUSION

Although the increase in syphilis positives among blood donors may be a reflection of the increase in the general population, the rate of increase was less pronounced among blood donors. Although the increase in the syphilis-positive rate may not affect blood product safety, it would have a significant impact on the number of potential blood donors in the future because the increase was more frequently observed in young donors and new donors, and currently, syphilis-positive individuals are permanently deferred from blood donation. The implementation of effective measures to prevent transmission in the general population is required.

Trends in syphilis seroreactivity among blood donors: A 17-year retrospective analysis and follow-up at a tertiary care hospital

BACKGROUND AND OBJECTIVES

This study aimed to assess the seroprevalence of syphilis among blood donors, evaluate the response rate of seroreactive donors, and investigate high-risk behaviors.

MATERIAL AND METHODS

The study presents a retrospective analysis of syphilis seroreactivity among blood donors over a 17 year period. Blood donations were screened for syphilis using the Rapid Plasma Reagin (RPR) card test. RPR-reactive blood units were discarded, and donors were notified for follow-up. A detailed history was obtained, including prior syphilis diagnoses, sexual practices, and potential high-risk activities. The donors who were repeatedly RPR reactive were referred for further confirmatory management.

RESULTS

A total of 569 (0.20 %) donors were found RPR reactive. A non-linear trend was observed between RPR reactivity and study period, donor age and donation status. RPR reactivity was significantly higher in repeat blood donors (p < 0.001). The mean donor return rate was significantly higher following introduction of phone calls along with letters for donor notification compared to notification via letters only (p < 0.001). Forty-five percent (n = 241) donors returned for repeat sample testing. Of these, 19 % (n = 45) tested negative on repeat RPR testing while 81.3 % (n = 196) remained RPR reactive and were referred for further management. On follow up of the latter group, 43.9 % (n = 86) donors were negative on confirmatory testing indicating biological false positives while 56.1 % (n = 110) donors were positive on confirmatory testing and were true positives. Of true positive donors, 90.9 % of donors reported engaging in high risk sexual behaviours.

CONCLUSION

There is a need to update syphilis screening guidelines in developing countries like India, incorporating combination testing to improve the accuracy of syphilis detection in blood donors.

Syphilis in a blood bank in Argentina: Prevalence trends and risk factors

BACKGROUND

Worldwide, there has been a worrying increase in the prevalence of syphilis. Blood banks have a major role in monitoring the trend of these events, despite the bias due to the altruistic donation strategy.

OBJECTIVES

To determine the seroprevalence of syphilis and analyse its association with defined risk factors among blood donors at the regional blood center at Hospital Prof. Dr. J. P. Garrahan, period 2016-2022.

MATERIALS AND METHODS

Donor screening was performed with treponemal and non-treponemal tests to determine the prevalence of active and past syphilis. Sociodemographic characteristics of donors were analysed and the association with potential risk factors was assessed.

RESULTS

A total of 72 874 donations were processed during the study period. The overall prevalence of specific anti-Treponema pallidum antibodies was 0.69% (95% CI = 0.63-0.75). Active syphilis seroprevalence was 0.30% (95% CI = 0.25-0.33). Not active syphilis seroprevalence was 0.39% (95% CI = 0.35-0.44). Anti-T. pallidum seroprevalence among first-time donations was 1.26% (95% CI = 1.14-1.38) while in repeat donations it was 0.16% (95% CI = 0.12-0.21). In univariate analysis, we found an association between syphilis and having a history of any sexually transmitted infection (OR: 5.09, 95% CI = 2.20-11.70, p < 0.01) and being first-time donors (OR: 3.48, 95% CI = 1.70-7.09, p = 0.0001).

CONCLUSION

Although the overall prevalence of syphilis is 0.69%, among repeat donors prevalence as low as 0.16% was found. This demonstrates the need to maintain and improve screening strategies and promotion of voluntary, altruistic and repeat donation.

A systematic review and meta-analysis of the prevalence and risk of syphilis among blood donors in Thailand

Despite rising rates of sexually transmitted infections (STIs) in Thailand, including syphilis, data on its prevalence and associated risk factors among blood donors remain scarce. This systematic review and meta-analysis aimed to estimate the prevalence of syphilis and identify the key risk factors among blood donors in Thailand to inform targeted interventions for enhanced blood safety.The study protocol was registered in PROSPERO (CRD42024560215) and conducted following PRISMA guidelines. Comprehensive searches were performed across major databases, including ProQuest, Journals@Ovid, Embase, Scopus, PubMed, and MEDLINE, to identify relevant studies. A random-effects model was used to calculate the pooled prevalence and odds ratios (ORs) for syphilis risk factors. Heterogeneity was quantified using the I² statistic, and meta-regression and subgroup analyses were employed to explore potential sources of heterogeneity. Publication bias was assessed using funnel plots and Egger's regression test. A total of 23 studies involving 1,142,910 blood donors were included. The pooled prevalence of syphilis among blood donors in Thailand was 0.42% (95% CI 0.27-0.66%, I²: 99.3%, number of infections: 6,173), with a decreasing trend over time. Male donors were significantly more likely to have syphilis (P < 0.0001; pooled OR: 1.76; 95% CI 1.53-2.03; I²: 34.2%, 651,019 participants). First-time donors also had an elevated risk of syphilis (P = 0.02; pooled OR: 2.02; 95% CI 1.10-3.70; I²: 94.0%, 215,245 participants). Additionally, the analysis revealed a significant association between increasing age and higher syphilis risk among blood donors. The systematic review and meta-analysis indicated that syphilis prevalence among blood donors in Thailand is declining; however, male and first-time donors, as well as older age groups, remain at higher risk. To enhance blood safety, targeted interventions are needed, including refining donor screening questionnaires, expanding educational campaigns for high-risk groups, and incorporating advanced screening technologies. Strengthening and regularly updating national screening policies will ensure the effective mitigation of syphilis transmission among blood donors in Thailand.

Syphilis-positive and false-positive trends among US blood donors, 2013-2023

BACKGROUND

US blood donors are tested for syphilis because the bacterial agent is transfusion transmissible. Here we describe trends over an 11-year period of donations positive for recent and past syphilis infections, and donations classified as syphilis false positive (FP).

METHODS

Data from January 1, 2013, to December 31, 2023 (11 years) were compiled for all American Red Cross blood donations to evaluate demographics/characteristics and longitudinal trends in donors testing syphilis reactive/positive. The prevalence of recent, past, and total (combination of recent/past) infections were evaluated, along with syphilis FP donations. Classification was based on known serological methods using treponemal and non-treponemal tests.

RESULTS

Approximately 53 million donations were included with 10,365 total syphilis infections (3463 recent and 6902 past; 0.02% total) and 48,719 FP (0.09%). Donor demographics, characteristics, and HBV/HCV/HIV nucleic acid testing reactivity differed among syphilis-positive and FP compared with nonreactive donations. Donors with a FP donation had high rates of subsequent donations testing syphilis positive (0.3%) and FP (7.7%). Median time from first FP to subsequent FP was observed to be 3.6 months. Recent infections increased over the 11 years, with past infections peaking in 2014 followed by increases in 2021-2023 paralleling recent infections. Repeating cycles of seasonal FP spikes occurred in the fall of 2013 and from 2017 to 2022 corresponding with vaccine administrations.

CONCLUSIONS

Syphilis infections in blood donors are trending upward, paralleling US population trends. Syphilis FP donors had high rates of subsequent FP and unexplained syphilis-positive donations. Seasonal syphilis FP spikes occurred for most years but are trending downwards.

Syphilis reactivity among blood donors in Brazil: associated factors and implications for public health monitoring

BACKGROUND

Increasing syphilis infection rates are a concerning issue worldwide. Blood donation screening is an opportunity to monitor the burden of asymptomatic infections, providing information on contemporary factors associated with infection and public health insights into transmission.

METHODS

Blood donations collected at five Brazilian blood centers between January 2020 and February 2022 were screened with treponemal or non-treponemal assays according to local protocols, followed by alternate Enzyme-Linked Immunosorbent Assay (ELISA); samples with reactive or indeterminate results in the alternate ELISA were further tested with the rapid plasma reagin (RPR), and categorized as RPR-positive or RPR-negative. RPR-positive donations were also grouped according to RPR titers (< 1:8 or ≥ 1:8). We report the prevalence of syphilis in first-time donors (FTD) and repeat donors (RD), as well as incidence in RD. Multivariable models were used to assess factors associated with RPR-positive syphilis. Additionally, we explored the relationship between syphilis positivity in FTD and syphilis cases registered by the Brazilian public health surveillance system from 2012 to 2022.

FINDINGS

Of 862,146 donations, 10,771 (1.3%) were reactive or indeterminate on screening; 7,541 available samples underwent additional testing. Of those, 5,876 (77.9%) tested positive or indeterminate on the alternate ELISA; 907 (12.0%) were RPR-negative, 2,980 (39.5%) were RPR-positive < 1:8, and 1,989 (26.4%) were RPR-positive with titers ≥ 1:8. The prevalence of syphilis including RPR-positive and RPR-negative cases was 2.5% among FTD and 0.6% among RD. The incidence of syphilis in RD was 90/105 person-years (95% CI 86-95), with younger age, male gender, Black and Mixed race (relative to White) and lower education associated with incident syphilis in RD. Blood donors had lower rates of syphilis compared to the general population, with correspondence between numbers in blood donors and congenital syphilis rates registered by the Brazilian surveillance system between 2012 and 2022.

CONCLUSION

The prevalence of syphilis was < 3% among FTD and < 1% among RD. We found wide variability according to donor characteristics, with gender, age, race, and schooling significantly associated with prevalent and incident RPR-positive syphilis in multivariable models. Syphilis occurrence among blood donors can be used to assess disease patterns in low-risk populations.

Transfusion-transmissible coinfections among US blood donors

BACKGROUND

Transfusion-transmissible infection (TTI) prevalence among US blood donors has been widely documented. Here we estimate the prevalence of donors presenting with ≥2 TTIs (multiple infections past or present referred to as coinfections) and describe their demographics and associations.

METHODS

Data from the Transfusion-Transmissible Infections Monitoring System were compiled for October 2020-September 2023 (3 years). Prevalence per million donations (pmd) was calculated for each TTI coinfection combination with demographic characteristics summarized. The odds of each TTI coinfection combination were estimated using logistic regression. Reactivity by NAT and/or serology (HIV, HBV, and HCV) defined donors as consensus positive (CP) for each infection while serology-based algorithms defined syphilis CP and the subset with active syphilis infections (ASIs).

RESULTS

About 22 million donations were included, with 212 coinfections (9.7 pmd). Around 2% of donations positive for any TTI (n = 10,516) were coinfections. Coinfection prevalence per TTI combination ranged from 0.3 pmd for HIV CP and HCV CP, to 4.3 pmd for HIV CP and syphilis CP. There were high proportions of coinfections from donors who were male, aged 25-54 years, white or black, first time, and residing in the southern US Census Region. The odds of a second TTI occurring in an individual donor with a TTI ranged from 23 (95% CI: 13, 41) times more likely for HBV CP and ASI to 395 (95% CI: 298, 524) times more likely for HIV CP and ASI.

CONCLUSIONS

Coinfections are relatively uncommon among blood donors in the United States; however, associations exist among HIV, HBV, HCV, and syphilis infections.

Prevalence of Non-Viral Bloodborne Pathogens Among Healthy Blood Donors in Western Mexico: Problems and Failures of Public Health Policy

BACKGROUND AND OBJECTIVES

Non-viral bloodborne diseases are a group of infections that are a public health problem worldwide. The incidence of diseases such as brucellosis and syphilis is increasing in the Americas and Europe. Chagas disease is an endemic problem in Latin America, the United States and Europe. This study aims to determine the prevalence of non-viral bloodborne diseases in blood donors and to discuss some issues related to federal regulations for the control and prevention of these infectious diseases in Mexico.

MATERIAL AND METHODS

A cross-sectional study was conducted in the Western National Medical Center Blood Bank, including 228,328 blood donors (2018-2023). Frequencies, percentages, means, standard deviation and confidence intervals (CI) were calculated for demographic data. Prevalences were expressed as rates per 100,000 with 95% CI.

RESULTS

Of 3949 seroreactive or undetermined blood donors at the first screening, a total of 682 (0.299%) completed their follow-up test and were positive for Treponema pallidum (478), Trypanosoma cruzi (83), or Brucella spp. (121). The overall prevalence for non-viral bloodborne diseases was 299 per 100,000 blood donors. The prevalence for syphilis, Chagas disease, and Brucella was 209, 36, and 53 per 100,000 respectively.

CONCLUSION

Federal regulations should be reviewed to formulate specific public health policies focused on controlling and preventing nonviral bloodborne diseases.

Higher rates of laboratory-confirmed cases of syphilis in Western Canadian blood donors compared with Eastern Canadian blood donors following a period of societal re-opening

BACKGROUND AND OBJECTIVES

There is a growing infectious syphilis outbreak in Western Canada. Although blood donors are screened for syphilis risks, some blood donors will still be confirmed test-positive for syphilis. This study compares the characteristics of confirmed test-positive syphilis donations in both Western Canada and Eastern Canada, November 2022-August 2023.

MATERIALS AND METHODS

Donors were defined as Western or Eastern Canadian. Blood donations were tested for syphilis using the PK-TP assay (Beckman Coulter PK7300 Automated Microplate System). Confirmatory Treponema pallidum particle agglutination (TPPA) and rapid plasma reagin (RPR) assays were performed by one of two reference laboratories. An RPR titre ≥1:8 was used as a proxy for possible infectious syphilis.

RESULTS

Rates of laboratory-confirmed syphilis were higher in Western (n = 43, 13.4/100,000 donations) versus Eastern donors (n = 19, 4.7/100,000 donations; Fisher's exact test, two-sided, p ≤ 0.0001). Most syphilis confirmations were in first-time donors (Western Canada n = 31/43, 72.1%, Eastern Canada 12/19, 63.2%).

CONCLUSION

Although rates of laboratory-confirmed syphilis were higher in Western versus Eastern donors, Western donors did not have higher rates of infectious syphilis. Further studies might assess whether donors with laboratory-confirmed syphilis understood pre-donation screening questions or were completely unaware of a past infection.

Blood safety markers in Dutch donors after relaxation of deferral for men who have sex with men: re-emergence of syphilis and HIV pre-exposure prophylaxis use

BACKGROUND

Less discriminatory donor selection policies for men who have sex with men (MSM) may impact transfusion safety in terms of higher residual risks for known transfusion-transmitted infections (TTIs), increased vulnerability toward new TTIs that are also transmitted via sex, and HIV infections masked by pre-exposure prophylaxis (PrEP).

STUDY DESIGN AND METHODS

TTI trends in Dutch donors were studied over a 13-year period (2011-2023), characterized by successive relaxations of MSM deferral criteria. Structured posttest counseling was performed to determine risk factors in TTI-positive donors. PrEP drug levels were measured in 9977 donations from male donors living in urban areas and in 67 donors with active or resolved syphilis.

RESULTS

HIV incidence (from 5.8 to 1.5 per 1,000,000 donor years (DY)) and HBV incidence (from 12.4 to 4.5 per 1,000,000 DY) in Dutch donors decreased with less stringent MSM deferral criteria, while syphilis prevalence (from 26.4 to 44.1 per 100,000 new donors) and syphilis incidence (from 18.3 to 46.3 per 1,000,000 DY) increased over time. The proportion of MSM-related syphilis rose from 2% to 32% in new donors and from 12% to 27% in repeat donors. PrEP was detected in 2 of 9977 (0.02%) donations from male donors living in urban areas, and in 1 of 39 (2.6%) male donors with syphilis.

DISCUSSION

To date, phasing out donor deferral for MSM had no significant impact on transfusion safety in the Netherlands. However, rising syphilis rates and (recent) PrEP use in the blood donor population, albeit rare, suggest an influx of donors with higher sexual risk profiles and requires intensified TTI surveillance in donors.

Improved efficiency using sequential automated immunoassays for syphilis screening in blood donors

Using sequential immunoassays for the screening of blood donors is well described for viral serology testing but not for the screening of syphilis. In this study, we report the evaluation results and 2-year sequential testing data using two highly sensitive automated serology assays, the Alinity s Syphilis chemiluminescent immunoassay for screening, with all repeatedly reactive samples then tested on the Elecsys Syphilis electrochemiluminescence immunoassay. We screened 1,767,782 blood donor samples between 7 July 2021 and 6 July 2023 and found the Alinity false-positive rate to be low at 0.08% (1,456/1,767,782). The common false-positive rate between the two assays was also low (3.83%, 58/1,514). Concordantly reactive samples were further tested using a Treponema pallidum particle agglutination test, a rapid plasma reagin test, and a fluorescent treponemal antibody absorption test. There were 262/1,376 concordantly reactive Alinity and Elecsys blood donor samples with reactivity on one or more of the confirmatory tests. A total of 26/1,376 donors had a current syphilis infection, 152/1,376 reported a past history of syphilis and had been treated, and 84/1,376 did not report a past history of syphilis. We suggest that future studies could explore the use of sequential immunoassays to aid in the serodiagnosis for syphilis.

IMPORTANCE

The serodiagnosis for syphilis usually follows two methodologies-a "traditional" algorithm using a non-treponemal test followed by confirmation using a treponemal test, or a "reverse" algorithm using a treponemal test followed by a non-treponemal test. There are limited reports in the literature of using a modified reverse algorithm (treponemal test followed by a second treponemal test), and to the best of knowledge, there are currently no published articles using two highly sensitive automated immunoassays to aid the serodiagnosis of syphilis. In addition, the Treponema pallidum particle agglutination (TPPA) assay is commonly used as a confirmatory test for the diagnosis of syphilis. With the withdrawal of the TPPA assay from Australia and presumably from the global market also, alternative testing algorithms are now required. This study provides proof of concept for using sequential immunoassays in the diagnosis of syphilis.

Syphilis testing in blood donors, France, 2007 to 2022

BackgroundSyphilis in blood donors (BD) has increased in many countries.AimWe aimed to describe trends in syphilis seroposivity in BD in France, to identify risk factors and assess if a non-treponemic test (NTT) could define BD having recovered from syphilis for more than 1 year.MethodsThe analysis covered the period 2007 to 2022 and 45,875,939 donations. Of the 474 BD syphilis-positive in 2022, 429 underwent additional investigations with an NTT. History of syphilis was obtained at the post-donation interview or based on serology results for repeat donors.ResultsUntil 2021, positivity rates remained stable (mean: 1.18/10,000 donations, range: 1.01-1.38). An increased rate was observed in 2022 (1.74/10,000; p = 0.02). Over the whole study period, prevalence was 2.2 times higher in male than in female BD (4.1 times higher in 2022). The proportion of males with an identified risk factor who have sex with men increased from 16.7% in 2007 to 64.9% in 2022. Based on NTT, 79 (18%) of the donors who were seropositive in 2022 were classified as having been infected in the previous year. History of syphilis was available for 30 of them. All had an infection within the previous 3 years. Among seven donors with a syphilis < 12 months before testing, one had an NTT titre ≥ 8, three a titre between 1 and 4, three were negative.ConclusionSyphilis seropositivity increased considerably in BDs in 2022, mostly in males, notably MSM. Available data did not allow appropriate evaluation of the NTT to distinguish recent from past infection.

A novel syphilis Treponema pallidum lipoprotein peptide antigen diagnostic assay using red cell kodecytes in routine blood centre column agglutination testing platforms

BACKGROUND AND OBJECTIVES

The detection of treponemal antibodies, which are used to make a diagnosis of syphilis, is important both for diagnostic purposes and as a mandatory blood donor test in most countries. We evaluated the feasibility of using Kode Technology to make syphilis peptide red cell kodecytes for use in column agglutination serologic platforms.

MATERIALS AND METHODS

Candidate Kode Technology function-spacer-lipid (FSL) constructs were made for the Treponema pallidum lipoprotein (TmpA) of T. pallidum, using the peptide and FSL selection algorithms, and then used to make kodecytes. Developmental kodecytes were evaluated against a large range of syphilis antibody reactive and non-reactive samples in column agglutination platforms and compared against established methodologies. Overall, 150 reactive and 2072 non-reactive Syphicheck assay (a modified T. pallidum particle agglutination) blood donor samples were used to evaluate the agreement rate of the developed kodecyte assay.

RESULTS

From three FSL-peptide candidate constructs, one was found to be the most suitable for diagnostics. Of 150 Syphicheck assay reactive samples, 146 were TmpA-kodecyte reactive (97.3% agreement), compared with 58.0% with the rapid plasmin reagin (RPR) assay for the same samples. Against the 2072 expected syphilis non-reactive samples the agreement rate for TmpA-kodecytes was 98.8%.

CONCLUSION

TmpA-kodecytes are viable for use as cost-effective serologic reagent red cells for the detection of treponemal antibodies to diagnose syphilis with a high level of specificity in blood centres. This kodecyte methodology also potentially allows for introduction of the reverse-algorithm testing into low-volume laboratories, by utilizing existing transfusion laboratory infrastructure.

Transfusion-Transmissible Infections Monitoring System (TTIMS). Changes in transfusion-transmissible infection prevalence and demographics among US blood donors during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic impacted the US blood supply. We compared blood donor demography and infectious disease prevalence before and during the pandemic using a large multicenter database.

METHODS

Data were categorized as "Before COVID-19" (March 2018-February 2020) or "During COVID-19" (March 2020-February 2022). Donor demographics, donation frequency, and infectious marker prevalence of HIV, HBV, and HCV were compared for the two time periods. The odds of a donor testing positive for these infections among the two time periods were calculated using multivariable logistic regression.

RESULTS

Our study assessed a total of 26,672,213 donations including 13,430,380 before and 13,241,833 during COVID-19. There were significantly more donations from donors who were female, aged 40 and older, white, and repeat, during COVID-19. Donation frequency comparison quantified the increase in donations from donors who were white, female, older, and repeat during the pandemic. The prevalence of HIV and HCV decreased significantly during COVID-19 compared to before, but not for HBV. For HIV, the adjusted odds of infection during the pandemic did not differ but for HBV, the odds were significantly more likely during the pandemic and were significantly lower for HCV.

DISCUSSION

Demographics and infectious disease marker prevalence changed during the COVID-19 pandemic in the United States. Prevalence of each infection in the donor population will continue to be monitored to determine if changes were specific to the pandemic period.