Multicenter comparison of serologic assays and estimation of human herpesvirus 8 seroprevalence among US blood donors
Multicenter comparison of serologic assays and estimation of human herpesvirus 8 seroprevalence among US blood donors
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DOI：
10.1046/j.1537-2995.2003.00490.x
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发表时间：
2003-09-01
期刊：
影响因子：
2.9
通讯作者：
Busch, MP
中科院分区：
文献类型：
--
作者：
Pellett, PE;Wright, DJ;Busch, MP
背景技术背景：作为评估人类疱疹病毒8型输血传播可能性的一部分（HHV-8或卡波西肉瘤相关疱疹病毒），在美国献血者中估计HHV-8血清阳性率，比较HHV-8血清学检测的性能，并检测捐献血液中HHV-8 DNA的存在。从1000名美国献血者（1994年和1995年收集）和21名卡波西肉瘤患者制备的1040份血浆标本的重复组在6个实验室进行了HHV-8抗体检测。对来自138名献血者的血液样本进行HHV-8 PCR，其中包括所有33名在至少两个实验室中检测为阳性的献血者和22名在至少一个实验室中检测为阳性的献血者。美国献血者中HHV-8血清阳性率估计为3.5%（95% CI，1.2%-9.8%），条件依赖潜在类别模型，3.0%（95% CI，2.0%-4.6%）通过条件独立潜在类模型，3.3%（95% CI，2.3%-4.6%）通过使用共识衍生的金标准（两个或多个实验室的阳性标本）;条件依赖模型最佳拟合数据。在该模型中，实验室特异性范围为96.6%至100%。敏感性范围很广，但95% CI重叠。HHV-8 DNA检测血液中没有138捐助者evaluated.CONCLUSIONS：医疗和行为筛查不消除HHV-8血清阳性的人从美国献血池，但没有发现病毒DNA在供体血液。为了更全面地评估病毒血症的发生率和HHV-8输血传播的可能性，还需要对大量血清学阳性个体进行进一步研究。目前的数据并不表明有必要对美国献血者进行HHV-8筛查。
BACKGROUND: As part of assessing the possibility of transfusion transmission of human herpesvirus 8 (HHV-8 or Kaposi's sarcoma-associated herpesvirus), HHV-8 seroprevalence was estimated among US blood donors, the performance of HHV-8 serologic tests was compared, and the presence of HHV-8 DNA was tested for in donated blood.STUDY DESIGN AND METHODS: Replicate panels of 1040 plasma specimens prepared from 1000 US blood donors (collected in 1994 and 1995) and 21 Kaposi's sarcoma patients were tested for antibodies to HHV-8 in six laboratories. HHV-8 PCR was performed on blood samples from 138 donors, including all 33 who tested seropositive in at least two laboratories and 22 who tested positive in at least one.RESULTS: The estimated HHV-8 seroprevalence among US blood donors was 3.5 percent (95% Cl, 1.2%-9.8%) by a conditional dependence latent-class model, 3.0 percent (95% Cl, 2.0%-4.6%) by a conditional independence latent-class model, and 3.3 percent (95% Cl, 2.3%-4.6%) by use of a consensus-derived gold standard (specimens positive in two or more laboratories); the conditional dependence model best fit the data. In this model, laboratory specificities ranged from 96.6 to 100 percent. Sensitivities ranged widely, but with overlapping 95 percent CIs. HHV-8 DNA was detected in blood from none of 138 donors evaluated.CONCLUSIONS: Medical and behavioral screening does not eliminate HHV-8-seropositive persons from the US blood donor pool, but no viral DNA was found in donor blood. Further studies of much larger numbers of seropositive individuals will be required to more completely assess the rate of viremia and possibility of HHV-8 transfusion transmission. Current data do not indicate a need to screen US blood donors for HHV-8.