Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2011 Jun;11(6):1176-87.
doi: 10.1111/j.1600-6143.2010.03329.x. Epub 2011 Mar 2.

Risk of window period HIV infection in high infectious risk donors: systematic review and meta-analysis

L M Kucirka  1 , H Sarathy, P Govindan, J H Wolf, T A Ellison, L J Hart, R A Montgomery, R L Ros, D L Segev
Affiliations
Meta-Analysis

Risk of window period HIV infection in high infectious risk donors: systematic review and meta-analysis

L M Kucirka et al. Am J Transplant. 2011 Jun.

Abstract

The OPTN defines high risk donors (HRDs), colloquially known as 'CDC high risk donors', as those thought to carry an increased risk of HIV window period (WP) infection prior to serologic detectability. However, the true risk of such infection remains unknown. To quantify the risk of WP infection in each HRD behavior category, we performed a systematic review and meta-analysis of studies of HIV prevalence and incidence. Of 3476 abstracts reviewed, 27 eligible studies of HIV infection in HRD populations were identified. Pooled HIV incidence estimates were calculated for each category of HRD behavior and used to calculate the risk of WP HIV infection. Risks ranged from 0.09-12.1 per 10 000 donors based on WP for ELISA and 0.04-4.9 based on nucleic acid testing (NAT), with NAT reducing WP risk by over 50% in each category. Injection drug users had the greatest risk of WP infection (4.9 per 10 000 donors by NAT WP), followed by men who have sex with men (4.2:10 000), commercial sex workers (2.7:10 000), incarcerated donors (0.9:10 000), donors exposed to HIV through blood (0.6:10 000), donors engaging in high-risk sex (0.3:10 000) and hemophiliacs (0.035:10 000). These estimates can help inform patient and provider decision making regarding HRDs.

PubMed Disclaimer

Conflict of interest statement

DISCLOSURE

The authors have no conflict of interest to disclose. This study was not funded in any way by a commercial organization.

Figures

Figure 1
Figure 1
Search/Selection *Some studies reported both HIV prevalence and incidence; unique studies included totaled 122 **A systematic review was recently performed on this topic and the estimates reported in this review were used to calculate the risk of WP infection in donors exposed to HIV
Figure 2
Figure 2
Equations Used in Meta-Analysis *Within each category, the total number of PYs at risk and the total number of sero-conversions were combined to derive pooled estimates for that category. Poisson exact 95% confidence intervals (CIs) were calculated for each pooled estimate; pooled incidence estimates and the bounds of their 95% CIs were used to derive the expected number of WP infections using the equation shown in (A)
See this image and copyright information in PMC

Comment in

References

    1. Minimum Procurement Standards for an Organ Procurment Organization. 2008. [cited 2008 September 12]; Available from: http://www.unos.org/PoliciesandBylaws2/policies/pdfs/policy_2.pdf.
    1. Ahn J, Cohen SM. Transmission of human immunodeficiency virus and hepatitis C virus through liver transplantation. Liver Transpl. 2008;14(11):1603–1608. - PubMed
    1. Hardy WD., Jr General principles of retrovirus immunodetection tests. J Am Vet Med Assoc. 1991;199(10):1282–1287. - PubMed
    1. Simonds RJ. HIV transmission by organ and tissue transplantation. AIDS. 1993;7 (Suppl 2):S35–38. - PubMed
    1. Singer AL, Kucirka LM, Namuyinga RHC, Subramanian AK, Segev DL. The high risk donor: viral infections in solid organ transplantation. Current Opinion in Organ Transplantation. 2008;13:400–404. - PubMed

Publication types