Iron status in Norwegian blood donors: comparison of iron status in new blood donors registered in 1993–1997 and in 2005–2006

Background and Objectives  The impact of a poor iron status on the difficulties to keep recruitment of new donors at pace with the ongoing increased demand for blood transfusions was studied by comparing the iron status of new donors recruited in 1993–1997 and in 2005–2006.
Materials and Methods  Iron status was defined by haemoglobin and serum ferritin. Inclusion criteria for approving new donors were haemoglobin ≥ 12·5 g/dl for women and ≥ 13·5 g/dl for men, and serum ferritin > 15 µg/l for both genders. Data were gathered retrospectively from 943 subjects (55% women) in the 1990 ties and prospectively from 1013 subjects (63% women) 10 years later.
Results  In women, there was a significant fall in haemoglobin and serum ferritin mean values from 13·2 to 13·1 g/dl and from 30·9 to 26·9 µg/l, respectively. Rejection due to low haemoglobin was significantly increased from 14% to 24%. In men, there were minor changes that did not affect rejection rates.
Conclusion  Iron status of women who want to serve as blood donors has deteriorated in the last 10 years, leading to an increased rejection due to haemoglobin below the inclusion criterion for blood donors.     

Detection of HHV‐8 (human herpesvirus‐8) genomes in induced peripheral blood mononuclear cells (PBMCs) from US blood donors

Background Human herpesvirus‐8 (HHV‐8) causes Kaposi’s sarcoma and can be detected and induced in peripheral blood mononuclear cells (PBMCs) from infected individuals. The prevalence of viral genomes in induced/cultured PBMCs from healthy blood donors has not been systematically studied. Materials and Methods PBMCs from 164 donors were purified and stored as two equal aliquots in liquid nitrogen. One aliquot was used for CD19⁺ B‐cell purification with a fraction reserved for DNA extraction. The second aliquot was cultured for 2 or 4 days in culture media containing n‐butyrate and tetradecanoyl phorbol acetate. DNA was extracted from all four cell sources: PBMCs, purified B cells, induced PBMCs harvested at days 2 and 4 of culture. A sensitive real‐time PCR with a DNA equivalent of 3 × 10⁵ cells per reaction was run in duplicate for all samples along with a quantitative HHV‐8 DNA standard ranging from 1·6 to 200 copies. Results For all 164 donors, HHV‐8 genomes were not detected in the DNA equivalent of 3–6 × 10⁵ of PBMCs and induced/cultured PBMCs with a real‐time PCR assay (95% CI: 0–3·5/164). HHV‐8 DNA was not detected from DNA equivalent of 1·5 (0·5–5·6) × 10⁵ CD19⁺ B cells from 139/164 donors. HHV‐8 antibodies were detected in 7 of the 164 donors (4·3%). Conclusions HHV‐8 genomes were not detected from PBMCs, induced/cultured PBMCs and CD19⁺ B cells from 164 blood donors. The level of detectable HHV‐8 genomes in blood donors seems to be extremely low, if they exist.     

New trends of HCV infection in China revealed by genetic analysis of viral sequences determined from first‐time volunteer blood donors

Summary. Recently, we studied hepatitis C virus (HCV) sera‐prevalence among 559 890 first‐time volunteer blood donors in China. From randomly selected 450 anti‐HCV positive donors, we detected HCV RNA in 270 donors. In this study, we amplified HCV E1 and/or NS5B sequences from 236 of these donors followed by DNA sequencing and phylogenetic analysis. The results indicate new trends of HCV infection in China. The HCV genotype distribution differed according to the donors’ region of origin. Among donors from Guangdong province, we detected subtypes 6a, 1b, 3a, 3b, 2a, and 1a at frequencies of 49.7%, 31.0%, 7.6%, 5.5%, 4.1%, and 2.1%, respectively. Among donors from outside Guangdong, we detected 1b, 2a, 6a, 3b, 3a, 6e, and 6n at frequencies 57.1%, 13.2%, 11.0%, 9.9%, 4.4%, 2.2%, and 2.2%, respectively. Although we found no significant differences among regions in age or gender, subtype 6a was more common (P < 0.001) in donors from Guangdong than those from elsewhere, whilst subtypes 1b (P < 0.02) and 2a (P < 0.001) were more frequent outside Guangdong. Disregarding origins, the male/female ratio was higher for subtype 6a‐infected donors (P < 0.05) than for subtype 1b donors, whilst the mean age of subtype 2a donors was 8–10 years older (P < 0.05) than that for all other subtypes. Detailed phylogenetic analysis of our sequence data provides further insight into the transmission of HCV within China, and between China and other countries. The predominance of HCV 6a among blood donors in Guangdong is striking and mandates studies into risk factors for its acquisition.     

Capillary and venous haemoglobin levels in blood donors: a 42‐month study of 36 258 paired samples

Background EU law requires a haemoglobin of ≥ 12·5 g/dl for women or ≥ 13·5 g/dl for men at the time of donation. As capillary and venous haemoglobin values may differ in the same subject, we examined whether a capillary haemoglobin level of 12·0 g/dl for women or 13·0 g/dl for men, is equivalent to a venous haemoglobin level of ≥ 12·5 g/dl and ≥ 13·5 g/dl, respectively, to avoid unnecessary loss of blood donations. Methods Over a continuous 42‐month period, 36 258 paired capillary and venous samples were taken from 25 762 females and 10 496 males, when the capillary haemoglobin was < 12·5 g/dl and < 13·5 g/dl respectively. Results Venous haemoglobin levels were higher than capillary levels, with a mean difference of 1·07 g/dl (SD 0·68 g/dl), range ?2·2 to +3·25 g/dl for men (P < 0·001), and a mean difference of 0·67 g/dl (SD 0·65 g/dl), range ?2·5 to +5·4 g/dl for women (P < 0·001). The difference for the three consecutive winters was 0·78 g/dl (SD 0·081 g/dl) for females and 1·26 g/dl (SD 0·162 g/dl) for males and for the three consecutive summers was 0·56 g/dl (SD 0·089 g/dl) for females and 0·88 g/dl (SD 0·134 g/dl) for males: P < 0·001. Conclusions Capillary haemoglobin levels of 12·0–12·5 g/dl in healthy females or 13·0–13·5 g/dl in healthy males are substantively equivalent to venous haemoglobin levels of ≥ 12·5 and ≥ 13·5 g/dl for women and men respectively. This finding has permitted an additional 32 990 blood units to be collected over the period of the study, a gain of 9·4%.     

Preoperative autologous blood donation in adult bone marrow donors: reappraisal of a single‐centre experience

To avoid risk for allogeneic transfusions in healthy bone marrow (BM) donors, 1–2 preoperative autologous blood donations (PAD) are usually collected before the BM harvest. We analysed the haematological parameters in BM donors before and after the harvest, to assess the efficacy of this practice in limiting the postharvest anaemia. Overall, 102 consecutive donors underwent BM harvest preceded by one (26 cases) or two PAD (76 cases), which were infused during BM collection. We analysed the parameters related to donors, PAD timing and BM graft characteristics. PAD induced a significant decrease in Hb (from 14·6 g/dl, IQ range 13·3–15·5 to12·9 g/dl, IQ range 11·8–13·9; P < 0·0001) in all donors, with a median Hb loss at day ?1 of 10·9% (IQ range 6·8–14·2). The PAD‐related Hb decrease was independent of sex or number of PAD, and was inversely related to the time elapsed from first or last PAD. In comparison with values recorded at day‐1, BM harvest produced an additional Hb decrease, accounting for a median Hb loss of 18·9% (IQ range 14·9–24·4). Overall, in comparison with pre‐PAD values, Hb levels at day +1 were reduced of 28·9% (IQ range 23·6–32·2), independently if donors had 1 or 2 PAD reinfused. In conclusion, these data show that two PAD do not carry any advantage over one PAD. An eventual benefit of PAD can be achieved only if an adequate interval between PAD and BM harvest elapses. Prospective randomized studies could be worth to establish if any role for PAD does exist in BM donors.     

Absence of nonprimate hepacivirus‐related genomes in blood donors seroreactive for hepatitis C virus displaying indeterminate blot patterns

Despite intensive search, no primate homologue to the Hepatitis C Virus (HCV) has ever been found. The search for a zoonotic origin for HCV has been renewed recently when a virus, now known as non‐primate hepacivirus (NPHV), with a high homology to HCV was found in dogs. A variable proportion of anti‐HCV reactive blood donors submitted to the immunoblot (IB) to confirm their HCV status, present indeterminate results. The degree of homology between HCV and NPHV suggests that humans may be infected by NPHV or NPHV‐like viruses. Maximum similarity between NHPV and HCV is observed in the nonstructural regions 3 and 5. Peptides representing both domains are present in IB assays, so it is reasonable to suppose that blood donors harboring such viruses may display cross‐reactivity to the HCV antigenic fractions. Fifty‐nine plasma samples from blood donors found reactive for anti‐HCV and presenting IB indeterminate results were submitted to five distinct PCR reactions under low‐stringency conditions, employing primers targeting GBV‐C 5'UTR and NS3, Flavivirus‐genus NS5 and NPHV 5'UTR and NS3. No amplification was obtained with all primer pairs tested except for five samples that amplified both 5'UTR and NS3 fragments from GBV‐C. Unbiased next‐generation sequencing may prove or rule out the existence of HCV‐related viruses in IB indeterminate samples.     

Reducing occupational sedentary time: a systematic review and meta‐analysis of evidence on activity‐permissive workstations

Excessive sedentary time is detrimentally linked to obesity, type 2 diabetes, cardiovascular disease and premature mortality. Studies have been investigating the use of activity‐permissive workstations to reduce sedentary time in office workers, a highly sedentary target group. This review systematically summarizes the evidence for activity‐permissive workstations on sedentary time, health‐risk biomarkers, work performance and feasibility indicators in office workplaces. In July 2013, a literature search identified 38 relevant peer‐reviewed publications. Key findings were independently extracted by two researchers. The average intervention effect on sedentary time was calculated via meta‐analysis. In total, 984 participants across 19 field‐based trials and 19 laboratory investigations were included, with sample sizes ranging from n = 2 to 66 per study. Sedentary time, health‐risk biomarkers and work performance indicators were reported in 13, 23 and 23 studies, respectively. The pooled effect size from the meta‐analysis was ?77 min of sedentary time/8‐h workday (95% confidence interval = ?120, ?35 min). Non‐significant changes were reported for most health‐ and work‐related outcomes. Studies with acceptability measures reported predominantly positive feedback. Findings suggest that activity‐permissive workstations can be effective to reduce occupational sedentary time, without compromising work performance. Larger and longer‐term randomized‐controlled trials are needed to understand the sustainability of the sedentary time reductions and their longer‐term impacts on health‐ and work‐related outcomes.     

Prevalence of seromarkers of HBV and HCV among blood donors in eastern Saudi Arabia, 1998–2001

The prevalence of serological markers of HBV and HCV were determined for blood donors in eastern Saudi Arabia. Between 1998 and 2001, 13 443 donors (10 778 Saudi and 2665 non‐Saudi), were screened for HBsAg, anti‐HBc Ab, and anti‐HCV Ab using commercial kits. There was a steady decrease in the HBsAg (2.58 and 1.67%), anti‐HBc rates (15.32 and 9.15%), and anti‐HCV (1.04 and 0.59%) rates between 1998 and 2001, respectively. However, there was a marked difference between Saudi and non‐Saudi donors with regard to anti‐HBc (P < 0.001) and anti‐HCV (P < 0.01), but not HBsAg prevalence rates in the same time period.