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Plenary Oral Abstract

Public Health/Policy and Ethics

Plenary Abstract

PL3-SN-08 - Transfusion-Transmissible Infection Prevalence in US Blood Donations: Comparison of 3-month Deferrals to Individual Donor Assessment

Sunday, October 26, 2025
10:00 AM - 11:30 AM  PT
Room: SDCC 20BC
Oral Abstracts
Background/Case Studies: The Transfusion-Transmissible Infections Monitoring System (TTIMS) assesses TTI trends in ~60% of the US blood supply. FDA eliminated its time-based deferral (3 months, 3M) for male donors who have sex with males (MSM) and female donors who have sex with MSM, and donor eligibility transitioned to individual donor assessment (IDA) in 2023. To assess the impact of this policy update, we compared HIV, HBV, HCV, and syphilis prevalence (Prv) in donations in these two policy periods.

Study

Design/Methods:

Two 15-month periods were selected for 3M and IDA, centered around blood collection organization-specific IDA implementation dates, which were between Aug and Oct 2023. All donations completing index testing with valid results for HIV, HBV, HCV, and syphilis were analyzed. Previously developed consensus-positive definitions for each agent, based on serology and NAT results, were used. Prv per 100,000 donations was calculated for each period and comparisons were made using Fisher’s exact test (p <0.05).

Results/Findings:

A total of 18,154,161 donations were evaluated for both periods combined, with 3M (49.6%) and IDA (50.4%) periods almost equally represented. There were more donations from donors who were male (52.0%), repeat (86.1%), aged ≥25 (89.6%), white (83.1%), and residing in the South (29.0%).
From 3M to IDA, HIV and HBV Prv remained stable (2.24-2.69; p=0.06 and 6.53-6.76; p=0.56, respectively), HCV Prv decreased (10.23-8.99; p< 0.01), and syphilis Prv increased (35.43-45.20; p< 0.01). Increases occurred in HIV Prv for concordant serology/NAT positives (CP) - a subset of consensus positives (1.73-2.20), those aged 25-54 (3.38-4.37), and those identifying as Hispanic/Latino (6.00-9.83) (all p<u><0.03). No significant changes were noted for HIV or HBV first-time or male donors. HBV Prv remained stable for all demographic subgroups, HCV Prv declined for most subgroups, e.g., CP (10.18-8.93), males (14.60-12.33), first-time donors (65.12-53.27), and repeat donors (1.84-1.44) (all p<u><0.05). Syphilis Prv increased overall for all consensus-positive and among demographic subgroups, while remaining stable for those with active infection (14.74-15.82; p=0.07).

Conclusions:

During the first 15 months of IDA, HIV and HBV Prv did not change, while HCV Prv declined and syphilis Prv increased. Increasing HIV rates among one of the largest donor age groups (25-54 years) and the Hispanic/Latino race/ethnicity group require ongoing monitoring. Monitoring over time will allow more robust prevalence and will allow incidence measures to confirm these early findings. Increasing syphilis rates reflect similar increases among the general population and, as true for decreases in HCV rates, are mostly due to old or resolving infections, rather than new ones.