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This study evaluated the usefulness of the anti-HBc, hepatitis C virus antibodies (anti-HCV), human T cell lymphotropic virus I and II antibodies (anti-HTLV I/II), serologic tests for syphilis, and surface antigen of hepatitis B virus (HBsAg) as surrogate markers for the risk for HIV infection in 80,284 serum samples from blood donors from the Blood Bank of "Hospital Universitrio Regional Norte do Paran", Londrina, Paran State, Brazil, analyzed from July 1994 to April 2001. Among 39 blood donors with positive serology for HIV, 12 (30.8%) were anti-HBc positive, 10 (25.6%) for anti-HCV, 1 (2.6%) for anti-HTLV I/I, 1 (2.6%) was positive for syphilis, and 1 (2.6%) for HBsAg. Among the donors with negative serology for HIV, these markers were detected in 8,407 (10.5%), 441 (0.5%), 189 (0.2%), 464 (0.6%), and 473 (0.6%) samples, respectively. The difference was statistically significant (p < 0.001) for anti-HBc and anti-HCV. Although the predictive positive values for these surrogate markers were low for HIV infection, the results confirmed the anti-HBc and anti-HCV as useful surrogate markers for HIV infection thus reinforcing the maintenance of them in the screening for blood donors contributing to the prevention of the small number of cases in which HIV is still transmitted by transfusion.
The present study demonstrated that the positive predictive values for the anti-HBc antibody, anti-HCV test and anti-HTLV I/II, were comparatively low among the first-time blood donors. The in vitro diagnostic studies should be aimed at improving the predictive accuracy for these markers, especially in the Brazilian population whose infection pattern for each of the above-mentioned agents is not the same as that observed for countries located in the northern hemisphere.
It is recommended that these surrogate markers be maintained and even extended until alternative markers are developed to replace the existing ones in the prevention of HIV infection by blood donation. Concerning the existing surrogate markers, the following actions are suggested. d2c66b5586