@article {270,
	title = {A new strategy for estimating risks of transfusion-transmitted viral infections based on rates of detection of recently infected donors.},
	journal = {Transfusion},
	volume = {45},
	year = {2005},
	month = {Feb},
	pages = {254 - 64},
	abstract = {Estimates for human immunodeficiency virus (HIV)-1 and hepatitis C virus (HCV) transfusion-transmitted risks have relied on incidence derived from repeat donor histories and imprecise estimates for infectious, preseroconversion window periods (WPs).|By use of novel approaches, WPs were estimated by back-extrapolation of acute viral replication dynamics. Incidence was derived from the yield of viremic, antibody-negative donations detected by routine minipool nucleic acid testing (MP-NAT) of 37 million US donations (1999-2002) or from sensitive/less-sensitive HIV-1 enzyme immunoassay (S/LS-EIA) results for seropositive samples from 6.5 million donations (1999). Incidences and WPs were combined to calculate risks and project yield of individual donation (ID)-NAT.|The HIV-1 WP from presumed infectivity (1 copy/20 mL) to ID-NAT detection was estimated at 5.6 days, and the periods from ID to MP-NAT detection and from MP-NAT to p24 detection at 3.4 and 6.0 days, respectively; corresponding estimates for HCV were 4.9, 2.5, and 50.9 days (the latter represents period from MP-NAT to HCV antibody detection). The HIV-1 incidence projected from MP-NAT yield or from S/LS-EIA data was 1.8 per 100,000 person-years, resulting in a corresponding HIV-1 transfusion-transmitted risk of 1 in 2.3 million. The HCV incidence from MP-NAT yield was 2.70 per 100,000 person-years with a corresponding risk of 1 in 1.8 million donations. Conversion from MP-NAT to ID-NAT was projected to detect two to three additional HIV-1 and HCV infectious units annually.|MP-NAT yield and S/LS-EIA rates can accurately project transfusion risks. HCV and HIV-1 risks, currently estimated at 1 per 2 million units, could be reduced to 1 in 3 to 4 million units by ID-NAT screening.},
	keywords = {Acute Disease, Blood Donors, Blood Transfusion, HIV Infections, HIV-1, Humans, Incidence, Predictive Value of Tests, Risk Factors},
	issn = {0041-1132},
	doi = {TRF04215 [pii] 10.1111/j.1537-2995.2004.04215.x},
	author = {Busch,M. P. and Glynn,S. A. and Stramer,S. L. and Strong,D. M. and Caglioti,S. and Wright,D. J. and Pappalardo,B. and Kleinman,S. H. and Group,NHLBI-REDS NAT Study}
}
