Profile of Blood Donors with Serologic Tests Reactive for the Presence of Syphilis in São Paulo, Brazil

Overview

Journal Transfusion

Specialty Hematology

Date 2008 Dec 2

PMID 19040599

Citations 9

Authors

Cesar de Almeida Neto

Edward L Murphy

William McFarland

Alfredo Mendrone Junior

Sanny Chen

Dalton A F Chamone

Ester C Sabino

Affiliations

Soon will be listed here.

Abstract

Background: Syphilis screening of blood donors is a common practice worldwide, but very little is known about the meaning of a positive serologic test for syphilis in blood donors and the risk profile of these donors. The aim of this study was to determine the demographic characteristics and risk behaviors of blood donors with recent and past syphilis and their implications for blood bank testing and deferral strategies.

Study Design And Methods: Demographic characteristics, category of donation, number of previous donations, sexual behavior, and history of sexually transmitted diseases were reviewed comparing blood donors with recent and past syphilis from January 1, 1999, to December 31, 2003.

Results: A total of 2439 interviews were reviewed, including 2161 (88.6%) donors with past and 278 (11.4%) with recent syphilis infection. Factors associated with recent infection included younger age (< or = 20 years odds ratio [OR], 36.5; 95% confidence interval [CI], 15.8-84.1), two previous donations (OR, 2.7; 95% CI, 1.9-3.9), male-male sex (homosexual OR, 8.2; 95% CI, 3.2-20.8; and bisexual OR, 11.4; 95% CI, 3.6-36.3), two or more partners in the past 12 months (OR, 2.3; 95% CI, 1.3-4.0), symptoms for syphilis (OR, 4.5; 95% CI, 2.8-7.1), and human immunodeficiency virus (HIV) seropositivity (OR, 39.6; 95% CI, 4.6-339.8). Community donors were also associated with recent syphilis infection (OR, 1.5; 95% CI, 1.2-1.9) compared to replacement donors.

Conclusion: Sexual history, including male-male sex and multiple partners, were strongly associated with recent syphilis infection, which in turn was strongly associated with HIV. Continuous and vigilant surveillance that includes assessing sexual history and other factors associated with syphilis are needed to guide blood safety policies.

Citing Articles

Demographic, risk factors and motivations among blood donors with reactive serologic tests for syphilis in São Paulo, Brazil.

Ferreira S, de Almeida-Neto C, Nishiya A, Oliveira C, Ferreira J, Alencar C Transfus Med. 2014; 24(3):169-75.

PMID: 24779667 PMC: 5061039. DOI: 10.1111/tme.12124.

Factors associated with failure of clinical screening among blood donors who have altered serological results in the Centro Regional de Hemoterapia de Ribeirão Preto.

Ferreira O, Passos A Rev Bras Hematol Hemoter. 2013; 34(6):411-5.

PMID: 23323063 PMC: 3545426. DOI: 10.5581/1516-8484.20120103.

Logistic model for determining factors associated with HIV infection among blood donor candidates at the Fundação HEMOPE.

Queiroz N, Sampaio D, Santos E, Bezerra A Rev Bras Hematol Hemoter. 2012; 34(3):217-21.

PMID: 23049423 PMC: 3459634. DOI: 10.5581/1516-8484.20120053.

Factors associated with HIV infection among blood donors.

Stosic B Rev Bras Hematol Hemoter. 2012; 34(3):186-7.

PMID: 23049416 PMC: 3459640. DOI: 10.5581/1516-8484.20120046.

Effectiveness of confidential unit exclusion in screening blood donors of the regional blood bank in Londrina, Paraná State.

Vogler I, Saito M, Spinosa A, da Silva M, Munhoz E, Reiche E Rev Bras Hematol Hemoter. 2012; 33(5):347-52.

PMID: 23049338 PMC: 3415772. DOI: 10.5581/1516-8484.20110097.

References

Ampofo W, Nii-Trebi N, Ansah J, Abe K, Naito H, Aidoo S . Prevalence of blood-borne infectious diseases in blood donors in Ghana. J Clin Microbiol. 2002; 40(9):3523-5. PMC: 130790. DOI: 10.1128/JCM.40.9.3523-3525.2002. View

Gardella C, Marfin A, Kahn R, Swint E, Markowitz L . Persons with early syphilis identified through blood or plasma donation screening in the United States. J Infect Dis. 2002; 185(4):545-9. DOI: 10.1086/338829. View

Orton S, Dodd R, Williams A . Absence of risk factors for false-positive test results in blood donors with a reactive test result in an automated treponemal test (PK-TP) for syphilis. Transfusion. 2001; 41(6):744-50. DOI: 10.1046/j.1537-2995.2001.41060744.x. View

Hook 3rd E, Peeling R . Syphilis control--a continuing challenge. N Engl J Med. 2004; 351(2):122-4. DOI: 10.1056/NEJMp048126. View

Aberle-Grasse J, Orton S, Notari 4th E, Layug L, Cable R, Badon S . Predictive value of past and current screening tests for syphilis in blood donors: changing from a rapid plasma reagin test to an automated specific treponemal test for screening. Transfusion. 1999; 39(2):206-11. DOI: 10.1046/j.1537-2995.1999.39299154737.x. View

Orton S . Syphilis and blood donors: what we know, what we do not know, and what we need to know. Transfus Med Rev. 2001; 15(4):282-91. DOI: 10.1053/tmrv.2001.26956. View

Vall-Mayans M, Casals M, Vives A, Loureiro E, Armengol P, Sanz B . [Reemergence of infectious syphilis among homosexual men and HIV coinfection in Barcelona, 2002-2003]. Med Clin (Barc). 2006; 126(3):94-6. DOI: 10.1157/13083877. View

Brant L, Bukasa A, Davison K, Newham J, Barbara J . Increase in recently acquired syphilis infections in English, Welsh and Northern Irish blood donors. Vox Sang. 2007; 93(1):19-26. DOI: 10.1111/j.1423-0410.2007.00923.x. View

Wendel S . Current concepts on transmission of bacteria and parasites by blood components. Vox Sang. 1994; 67 Suppl 3:161-74. DOI: 10.1111/j.1423-0410.1994.tb04568.x. View

10.

Singh A, Romanowski B . Syphilis: review with emphasis on clinical, epidemiologic, and some biologic features. Clin Microbiol Rev. 1999; 12(2):187-209. PMC: 88914. DOI: 10.1128/CMR.12.2.187. View

11.

Zeltser R, Kurban A . Syphilis. Clin Dermatol. 2004; 22(6):461-8. DOI: 10.1016/j.clindermatol.2004.07.009. View

12.

Almeida Neto C, McFarland W, Murphy E, Chen S, Nogueira F, Mendrone Jr A . Risk factors for human immunodeficiency virus infection among blood donors in Sao Paulo, Brazil, and their relevance to current donor deferral criteria. Transfusion. 2007; 47(4):608-14. DOI: 10.1111/j.1537-2995.2007.01161.x. View

13.

Marfin A, Liu H, Sutton M, Steiner B, Pillay A, Markowitz L . Amplification of the DNA polymerase I gene of Treponema pallidum from whole blood of persons with syphilis. Diagn Microbiol Infect Dis. 2001; 40(4):163-6. DOI: 10.1016/s0732-8893(01)00275-9. View

14.

Schmunis G, Zicker F, Pinheiro F . Risk for transfusion-transmitted infectious diseases in Central and South America. Emerg Infect Dis. 1998; 4(1):5-11. PMC: 2627657. DOI: 10.3201/eid0401.980102. View

15.

Salles N, Sabino E, Barreto C, Barreto A, Otani M, Chamone D . [The discarding of blood units and the prevalence of infectious diseases in donors at the Pro-Blood Foundation/Blood Center of São Paulo, São Paulo, Brazil]. Rev Panam Salud Publica. 2003; 13(2-3):111-6. DOI: 10.1590/s1020-49892003000200011. View

16.

Pietravalle M, Pimpinelli F, Maini A, Capoluongo E, Felici C, dAuria L . Diagnostic relevance of polymerase chain reaction technology for T. pallidum in subjects with syphilis in different phases of infection. New Microbiol. 1999; 22(2):99-104. View

17.

Orton S, Liu H, Dodd R, Williams A . Prevalence of circulating Treponema pallidum DNA and RNA in blood donors with confirmed-positive syphilis tests. Transfusion. 2002; 42(1):94-9. DOI: 10.1046/j.1537-2995.2002.00023.x. View

18.

Herrera G, Lackritz E, Janssen R, Raimondi V, Dodd R, Aberle-Grasse J . Serologic test for syphilis as a surrogate marker for human immunodeficiency virus infection among United States blood donors. Transfusion. 1997; 37(8):836-40. DOI: 10.1046/j.1537-2995.1997.37897424407.x. View

19.

LARSEN S, Steiner B, Rudolph A . Laboratory diagnosis and interpretation of tests for syphilis. Clin Microbiol Rev. 1995; 8(1):1-21. PMC: 172846. DOI: 10.1128/CMR.8.1.1. View

20.

Kothe F . Transfusion syphilis: a case report. Sex Transm Dis. 1983; 10(4):200-1. DOI: 10.1097/00007435-198311000-00009. View