Residual risk of transfusion in Ghana

Plasma samples from replacement and volunteer blood donors in Kumasi, Ghana were pooled and tested using a duplex human immunodeficiency virus (HIV) and hepatitis C virus (HCV) RNA detection method. Individual plasmas constitutive of reactive pools were confirmed using reverse transcription-polymerase chain reaction. HIV and HCV infections were significantly higher in 1569 replacement donors than in 1169 volunteers; 2.4 and 1.7 versus 0.3 and 0.7% respectively (P < 0.01). Two duplex RNA-positive plasma pools contained a confirmed/seronegative HIV or HCV RNA individual plasma. The residual post-transfusion risk of HIV and HCV infection of blood collected from replacement blood donors ranged between 1:260 and 1:16 393 after screening for anti-HIV, p24 antigen and anti-HCV. These data indicate that in high-prevalence HIV and HCV blood donor populations, a substantial residual post-transfusion risk of infection remains. This risk might be reduced by collecting blood in younger volunteer donors or by genomic screening.