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Window period donations during primary cytomegalovirus infection and risk of transfusion‐transmitted infections
Author(s) -
Ziemann Malte,
Heuft HansGert,
Frank Kerstin,
Kraas Sabine,
Görg Siegfried,
Hennig Holger
Publication year - 2013
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.12074
Subject(s) - seroconversion , window period , medicine , cytomegalovirus , betaherpesvirinae , immunology , antibody , human cytomegalovirus , viremia , virology , viral disease , herpesviridae , virus , serology
Background Donors with short interdonation intervals (e.g., apheresis donors) have an increased risk of window period donations. The frequency of cytomegalovirus ( CMV ) window period donations is important information to decide whether selection of seronegative donors might be advantageous for patients at risk for transfusion‐transmitted CMV infections ( TT‐CMV ). Study Design and Methods CMV seroconversion in 93 donors with positive results in routine CMV antibody testing within at most 35 days after the last seronegative sample was evaluated by W estern blot and/or a second antibody test. In donors with unconfirmed seroconversion, an additional later sample was tested. Concentration of CMV DNA was determined in pre‐ and postseroconversion samples. Results CMV seroconversion was confirmed in 12 donors (13%). Among these, the last seronegative sample was CMV DNA positive in three donors (25%, below 30 IU / mL ). The first seropositive sample was CMV DNA positive in 10 donors (83%, maximum 1600 IU / mL ). Both prevalence and median concentration of CMV DNA were higher in the first seropositive sample (p = 0.004 and p = 0.02), with maximum concentrations being reached about 2 weeks after seroconversion. No CMV DNA was detected in samples from donors with unconfirmed seroconversion. Conclusion At least in donors with short interdonation intervals, most suspected CMV seroconversions are due to false‐positive results of the screening test. As window period donations are rare and contain less CMV DNA than the first seropositive donation, avoidance of blood products from primarily seropositive donors is especially helpful to avoid TT‐CMV if donors with short interdonation intervals are concerned.