Background Donor Suitability Consultation was held in Atlanta June 26-27, 2001 To review and consult on the 1994 CDC Guidelines for Preventing Transmission of Human Immunodeficiency Virus Through Transplantation of Human Tissue and Organs, MMWR 1994 Consultation was sponsored by CDC, in collaboration with FDA, HRSA, and NHLBI
Data Sources for Incidence and Prevalence Tables CDC contracted an independent research firm to perform a methodological literature search of the published English language scientific literature as background for the consultation Literature search concentrated on articles published from Consultation planning committee members provided unpublished data Subject matter experts reviewed tables for additional data
Literature Search Strategy Performed by Analytical Sciences, Inc. Databases – MEDLINE, AIDSLINE, EMBASE Concentrated on U.S. populations Title search, followed by abstract review and then full article review Supplemented by examining citation lists of key review articles
Search Areas Modes of transmission Infectious diseases Donor selection and screening processes Characteristics, risk behaviors and experiences of potential donors Incidence and Prevalence –
Summary Statistics on Literature Search Initially about 10,000 articles in title search Over 2,000 in abstract review Approximately 450 articles in final bibliography
Incidence and Prevalence Tables Infectious Agents - HIV, Hepatitis B, and Hepatitis C Attempted to find incidence and prevalence rates for various U.S. populations, subpopulations and risk groups Data was not found for all groups
Prevalence Heterosexuals attending STD clinics Compared to the general population, prevalence rates among heterosexuals attending STD clinics are 3 times higher for hepatitis B 3 times higher for hepatitis C 8 times higher for HIV
Prevalence Men Who Have Sex with Men Compared to the general population, prevalence rates among men who have sex with men are 5 times higher for hepatitis B 21 to 61 times higher for HIV
Prevalence Commercial Sex Workers Compared to the general population, prevalence rates among commercial sex workers are 21 times higher for hepatitis B 6 times higher for hepatitis C 77 times higher for HIV
Prevalence Injection Drug Users Compared to the general population, prevalence rates among injection drug users are 35 to 37 times higher for hepatitis B 43 to 48 times higher for hepatitis C 17 to 68 times higher for HIV
Incidence Heterosexuals attending STD Clinics Compared to the general population, incidence rates among heterosexuals attending STD clinics are 29 to 167 times higher for HIV
Incidence Men Who Have Sex with Men Compared to the general population, incidence rates among men who have sex with men are 87 to 193 times higher for HIV
Incidence Commercial Sex Workers Compared to the general population, incidence rates among commercial sex workers are 12 to 313 times higher for HIV
Incidence Injection Drug Users Compared to the general population, incidence rates among injection drug users are 145 times higher for hepatitis B 457 to 1493 times higher for hepatitis C 47 to 233 times higher for HIV
Prevalence Blood Donors Compared to the general population, prevalence rates among blood donors are 288 times lower for hepatitis B 11 to 23 times lower for hepatitis C 8 to 20 times lower for HIV
Incidence Blood Donors Compared to the general population, prevalence rates among blood donors are 17 times lower for hepatitis B 3.5 times lower for hepatitis C 2 to 5 times lower for HIV