Journal article
Reconsideration of blood donation testing strategy for human T-cell lymphotropic virus in Australia
Vox Sanguinis, Vol.112(8), pp.723-732
2017
Abstract
Background and Objectives
Universal testing of blood donations for human T-cell lymphotropic virus (HTLV) in Australia may no longer be appropriate given the low prevalence of HTLV infection and the mitigating effect of universal leucodepletion for cellular components. This study aimed to determine the most appropriate HTLV testing strategy using the Risk-Based Decision-Making Framework for Blood Safety.
Materials and Methods
The risk of HTLV transfusion–transmission using three testing strategies (universal, new-donor and no testing) and cost-effectiveness of the first two strategies were assessed using adaptations of published mathematical models.
Results
The overall prevalence for 2004–2014 was three HTLV-positives per million donations. It was estimated that annually, universal testing incurred a cost of approximately AUD $3 million and prevented 83 HTLV-positive cellular components from being issued, and new-donor testing cost approximately $225 000 and prevented 81 components. The number of cases of transfusion-transmitted HTLV and HTLV-associated disease prevented per year by universal and new-donor testing was essentially equivalent. According to preset risk thresholds, the risk of transfusion–transmission was negligible for universal and new-donor testing, and minimal without testing.
Conclusion
Transfusion–transmission of HTLV is a minimal risk in Australia even without testing. However, any revision of testing strategy must consider not only risk and cost-effectiveness, but also stakeholder, ethical and regulatory perspectives. Considering all relevant criteria, new-donor testing is judged the optimal strategy because it is able to achieve almost the same outcomes as universal testing, at a fraction of the cost.
Details
- Title
- Reconsideration of blood donation testing strategy for human T-cell lymphotropic virus in Australia
- Authors/Creators
- C.E. Styles (Author/Creator) - Australian Red Cross LifebloodC.R. Seed (Author/Creator) - Australian Red Cross LifebloodV.C. Hoad (Author/Creator) - Australian Red Cross LifebloodS. Gaudieri (Author/Creator) - Murdoch UniversityA.J. Keller (Author/Creator) - Australian Red Cross Lifeblood
- Publication Details
- Vox Sanguinis, Vol.112(8), pp.723-732
- Publisher
- Wiley
- Identifiers
- 991005542343007891
- Copyright
- © 2017 International Society of Blood Transfusion
- Murdoch Affiliation
- Institute for Immunology and Infectious Diseases
- Language
- English
- Resource Type
- Journal article
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- Collaboration types
- Domestic collaboration
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- Citation topics
- 1 Clinical & Life Sciences
- 1.66 HIV
- 1.66.1464 HTLV-1/BLV Pathogenesis
- Web Of Science research areas
- Hematology
- ESI research areas
- Clinical Medicine