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BACKGROUND: Infectious window period donations slip through routine donor screening procedures. To explore the potential value of predonation screening of candidate donors, we compared the proportion of incident transfusion-transmissible infections in candidate donors, in first-time donors, and in repeat donors. STUDY DESIGN AND METHODS: A retrospective analysis was performed of all incident hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections in candidate, first-time, and repeat donors in the Netherlands during the period 2009 to 2013. RESULTS: In total, 176,716 candidate donors, 144,226 first-time donations, and 4,143,455 repeat donations were screened for HBV, HCV, and HIV infection. Acute HBV infection was identified in the predonation sample of six candidate donors. One first-time donor, testing HIV-negative at predonation screening, tested positive for anti-HIV and HIV RNA in the first donation 29 days later. Among repeat donations we identified 15, one, and six incident HBV, HCV and HIV infections, respectively. The proportion of incident infections among candidate donors/first-time donations/repeat donations was for HBV, 3.40/0/0.36; for HCV, 0/0/0.02; and for HIV 0/0.69/0.14 per 100,000, respectively. CONCLUSION: Predonation screening of candidate donors very likely causes a loss of donations, but it might prevent undetected window period donations. Further studies are necessary to determine the value of predonation screening as an additional safety measure. [ABSTRACT FROM AUTHOR]

BACKGROUND: To improve transfusion policy and to increase understanding of the spread of hepatitis C virus (HCV) in the general population, HCV infections among voluntary Dutch blood donors were examined with molecular epidemiologic techniques. STUDY DESIGN AND METHODS: During 6 years, 1997 through 2002, confirmed anti-HCV–positive donors were interviewed on HCV-associated risk behavior with a standardized questionnaire. Additionally, HCV isolates were genotyped, partially sequenced, and compared to sequences obtained from Dutch injecting drug users (IDUs). RESULTS: HCV prevalence and incidence rates among Dutch donors were extremely low; the residual risk of transmitting HCV was calculated to be 1 in 30 million donations. Former IDUs (21%), transfusion recipients (30%), and immigrants (>12%) were identified as major HCV risk groups. Cryptogenic transmission caused 18 percent of infections among new donors and all infections among repeat donors. Compared to IDUs, genotype distribution among donors was highly diverse; major subtypes were 3a (27%), 1a (24%), 1b (24%), 2a/b (10%), and 4 (9%). Half of the donors were infected with IDU-related subtypes 1a and 3a, whereas subtype 1b mainly spread via blood transfusion and various other nosocomial modes of transmission in the past. HCV infections acquired in endemic countries could be clearly identified based on genotype. CONCLUSION: Different modes of transmission are linked to infections with certain HCV subtypes, suggesting separate HCV epidemics, but spillover between different risk groups underlines the value of molecular epidemiologic techniques to gain insight into the origin and dynamics of HCV infections on a population level. [ABSTRACT FROM AUTHOR]