1. Prevalence and risk relationships of tattoo, acupuncture and skin/body piercing histories among American Red Cross blood donors Sharyn Orton, MSPH, PhD FDA, Regulatory Project Manager, Division of Blood Applications and Roger Dodd, PhD ARCNET Epidemiology Group American Red Cross Holland Laboratory, Rockville, MD

2. ARC Donor History Question “In the past 12 months, have you had a tattoo, ear/body piercing, acupuncture, accidental needlestick, or come into contact with someone else’s blood?” Since 12/00, includes “or taken (snorted) cocaine or any other street drug through your nose”.

3. Objectives Prevalence Donor demographics Describe returning donors

4. MACS Database

5. Database Donations, donor demographics, infectious disease markers and deferrals –For this analysis from 1/1/1998 through 9/30/2001 Includes data from all 35+ ARC Blood Regions

6. Prevalence of TAP Deferral YearTAPOf total deferralsTotal donations 199818981445592 (4.3%)6.4 million 199930677571353 (5.4%)6.6 million 200028481776866 (3.7%)6.8 million 2001 (thru 9/01) 24421877720 (2.8%)7.3 million Total1025602671531 (3.8%) 27.1 million

7. Demographics of TAP deferred donors YearSex Age 1998Females: 58% Males: 42% Mean = 27 yrs Median = 22 yrs 1999Females: 57% Males: 43% No change 2000Females: 56% Males: 44% No change 2001*Females: 56% Males: 44% No change

8. Returning TAP Deferred Donors 24024 donors returned (volunteer or directed) –Of 102560 Gave 55599 total donations Time between deferral and subsequent return –Mean = 438 days –Median = 365 days

9. Infectious Disease Markers At time of return donation –2 anti-HIV –0 anti-HCV –0 HBsAg –0 anti-HTLV –0 syphilis –123 anti-core

10. HIV infected donors* Donor 1 –Female, age 27 –Volunteer whole blood –First-time donor, no other positive marker –HIV + at return donation 364 days after TAP deferral

11. continued Donor 2 –Female, age 20 –Volunteer whole blood donor –Repeat donor (x 4) –No other positive markers –HIV + at return donation 350 days after TAP deferral –Deferral for low Hgb 5 months previously –Last successful donation 19 months previously

12. Comments Unable to assess impact of “snorting drugs” addition to the question because of short follow- up time since implementation No indication of incident or prevalent HBV or HCV infection Two donors HIV + at follow-up donation; relationship to TAP risk is unknown

13. HCV NAT Interview Study

14. Methods Anti-HCV negative, initially HCV RNA positive 3/1/99 – 12/31/2001 –653 invited to participate 230 enrolled –39 true HCV NAT positive –191 false positive controls Additional samples and an extensive survey questionnaire

15. Questions In the 6 months prior to donation have you: –Been tattooed –Had any part of your body pierced

16. Results No donor reported any body piercing or acupuncture 4 donors reported tattooing –3 cases; 1 control 2 cases reporting tattooing also reported IDU

17. Comments Preliminary data Small numbers No overwhelming evidence of HCV transmission by tattoo