Risk factors associated with HIV infection in four large Brazilian blood centers: A multicentric case-control study (2009–2017)

Abstract

Background

Strategies to reduce contamination by transfusion-transmissible infections are constantly evolving. Over the years, HIV residual risk has decreased in several countries. However, in Brazil a recent study showed that the residual risk remains substantially higher than in other countries. Continuous surveillance of risk behaviors for infection in donors can help in pre-donation screening to reduce the risk of HIV in blood transfusions.

Methods

This analysis evaluated risk factors related to HIV infection among blood donors from four large Brazilian blood centers located in São Paulo, Rio de Janeiro, Belo Horizonte and Recife, from 2009–2017. A binary logistic model was used to evaluate any association between risk characteristics and behaviors and the occurrence of HIV. The significant variables were included in a saturated model, to which the backward strategy was applied to arrive at the final model. The analyses were carried out using the R program version 4.1.2 and p-value <0.05 was considered significant.

Results

A total of 1507 blood donors were included in the study, 716 were HIV positive and 791 were uninfected controls. Demographics significantly associated with infection were: Male sex, incomplete secondary education, separated/divorced/widowed, and bisexual/homosexual orientation. Behaviors most strongly associated with infection were: workplace exposure, intravenous drugs and men who had sex with other men.

Conclusion

The risk factors identified suggest that the blood donor screening process in Brazilian blood centers does not adequately identify donors at increased risk for HIV and further studies should be carried out to support changes to improve the process.