POTENTIAL INCREASED RISK OF VIRUS TRANSMISSION DUE TO EXCLUSION OF OLDER DONORS BECAUSE OF CONCERN OVER CREUTZFELDT-JAKOB-DISEASE

BACKGROUND: Concern over the theoretical possibility of disease transm ission via blood from donors who develop Creutzfeldt-Jakob disease has led to proposals to exclude older individuals from donating plasma fo r further manufacture into pooled plasma donations. The impact of exte nding this age-deferral policy to blood donors was examined with respe ct to the risk for known transmissible viruses. STUDY DESIGN AND METHO DS: Demographic characteristics and confirmed prevalence rates (/10(5) first-time donations) and incidence rates (/10(5) person-years for re peat donors) for viral markers were compared for donors <50 years old (n = 1,259,805 [85%]) and greater than or equal to 50 years old (n = 2 19,856 [15%]) and for donors <60 years old (n = 1,409,176 [95%]) and g reater than or equal to 60 years old (n = 70,485 [5%]). Incidence rate s were combined with infectious window-period estimates for each virus , to calculate the risk of virus transmission per 10(6) donations. RES ULTS: Unadjusted prevalence rates were significantly greater for young er than for older donor groups for human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg), and hepatitis C virus (HCV) (p l ess than or equal to 0.05). Incidence rates (and transmission risk est imates) for HBsAg were significantly higher in the <50 donor group tha n in the greater than or equal to 50 group (p>0.05), and those for HIV , human T-lymphotropic virus, and HCV were not significantly higher (p >0.05). Blanket removal of donors over the age of 50 would potentially lead to the following significant increases in the risk of infected u nits: HIV, 12 percent; HCV, 21 percent; and hepatitis B virus (HBsAg), 22 percent. CONCLUSION: Removal of donors over the age of 60 would no t significantly affect the risk of infected units. Deferral of donors greater than or equal to 50 years of age from whole-blood donations fo r unfounded concerns about Creutzfeldt-Jakob disease could have advers e effects on both blood availability and safety.