{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:43:03Z","timestamp":1791477783897,"version":"4.3.4"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,9,28]],"date-time":"2018-09-28T00:00:00Z","timestamp":1538092800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>In 1998 we estimated that 34\/million infectious window period donations were entering the blood supply at the South African National Blood Service. Selective use of donations based on donor race\u2010ethnicity reduced this risk to 26\/million donations but was deemed unethical. Consequently, in 2005 South African National Blood Service eliminated race\u2010ethnicity\u2013based collection policies and implemented individual\u2010donation nucleic acid testing (ID\u2010NAT). We describe the change in donor base demographics, human immunodeficiency virus (HIV) detection rates, and transfusion\u2010transmissible HIV risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>STUDY DESIGN AND METHODS<\/jats:title><jats:p>In ten years 7.7 million donations were tested for anti\u2010HIV and HIV RNA. Number of donations, HIV prevalence, ID\u2010NAT yield rate, serology yield rate and residual transfusion\u2010transmissible HIV risk were analyzed by donor type, race\u2010ethnicity, age, and sex. Multiple regression analysis was performed to investigate the determinants of HIV\u2010positive and nucleic acid testing yield donations.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The combined strategy of increasing donations from black donors and implementing ID\u2010NAT increased the proportion of donations from black donors from 6% in 2005 to 30% in 2015 (p &lt; 0.00001), and reduced the transfusion\u2010transmissible risk from 24 to 13 per million transfusions. ID\u2010NAT interdicted 481 (1:16,100) seronegative window period donations, while one transfusion\u2010transmissible case (0.13 per million) was documented. Race\u2010ethnicity and donor type were highly significant predictors of HIV positivity, with adjusted odds ratio for first\u2010time donors of 12.5 (95% confidence interval, 11.9\u201013.1) and for black race\u2010ethnicity of 31.1 (95% confidence interval, 28.9\u201033.4). The proportion of serology yields among HIV\u2010infected donors increased from 0.27% to 2.4%.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>ID\u2010NAT enabled the South African National Blood Service to increase the number of donations from black donors fivefold while enhancing the safety of the blood supply.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.14959","type":"journal-article","created":{"date-parts":[[2018,9,29]],"date-time":"2018-09-29T00:06:43Z","timestamp":1538179603000},"page":"267-276","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Assessment of HIV transfusion transmission risk in South Africa: a 10\u2010year analysis following implementation of individual donation nucleic acid amplification technology testing and donor demographics eligibility changes"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4383-4526","authenticated-orcid":false,"given":"Marion","family":"Vermeulen","sequence":"first","affiliation":[{"name":"South African National Blood Service  Roodepoort South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nico","family":"Lelie","sequence":"additional","affiliation":[{"name":"Lelie Research  Alkmaar The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charl","family":"Coleman","sequence":"additional","affiliation":[{"name":"South African National Blood Service  Roodepoort South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Sykes","sequence":"additional","affiliation":[{"name":"South African National Blood Service  Roodepoort South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genevieve","family":"Jacobs","sequence":"additional","affiliation":[{"name":"South African National Blood Service  Roodepoort South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronel","family":"Swanevelder","sequence":"additional","affiliation":[{"name":"South African National Blood Service  Roodepoort South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Busch","sequence":"additional","affiliation":[{"name":"Blood Systems Research Institute  San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gert","family":"van Zyl","sequence":"additional","affiliation":[{"name":"Division of Medical Virology Faculty of Medicine and Health Sciences, Stellenbosch University  Parow South Africa"},{"name":"National Health Laboratory Service, Tygerberg Business Unit  Parow South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduard","family":"Grebe","sequence":"additional","affiliation":[{"name":"DST\u2010NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA) Stellenbosch University  Stellenbosch South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Welte","sequence":"additional","affiliation":[{"name":"DST\u2010NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA) Stellenbosch University  Stellenbosch South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi","family":"Reddy","sequence":"additional","affiliation":[{"name":"South African National Blood Service  Roodepoort South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,28]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"Statistics South Africa. 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