Publications by authors named "Chyang Fang"

Background: Cytomegalovirus (CMV) transfusion-transmitted disease (TTD) remains a clinical concern. Universal leukoreduction has become one of the main strategies for the prevention of CMV-TTD. Through prospective clinical follow-up and testing of transfusion recipients (TRs), the risk for CMV-TTD was studied.

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Background: Committed repeat donors are vital to the continued success of blood collections, yet the effect of age of first-time (FT) donation on return behavior is poorly described. Sixteen-year-old donors are increasingly allowed to donate and have the highest rates of adverse events, which negatively impacts return behavior.

Study Design And Methods: Annual cohorts of allogeneic FT donors from 2005 and 2006 were selected within the American Red Cross system and followed for 25 and 13 months, respectively.

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Background: There have been few recent systematic studies of blood recipients for direct evidence of blood safety, especially for emerging pathogens that may pose a threat to the blood supply.

Study Design And Methods: Recipients who would likely require transfusion from multiple donors were recruited and a blood specimen was collected before their first study transfusion and at intervals after their study transfusion(s). Blood samples associated with the units that were transfused to enrolled recipients were also collected.

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Background: This study used two approaches to estimate the current incidence of hepatitis B virus (HBV) in a US donor population.

Methods: HBV incidence was estimated through the hepatitis B surface antigen (HBsAg) yield approach and the seroconversion method. Residual risk was estimated by the incidence–window period model.

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Background: Serologic screening for syphilis has been justified in part as a surrogate marker for infections caused by other pathogens such as human immunodeficiency virus (HIV). This study assessed the current surrogate value of the test.

Study Design And Methods: Testing results for blood donors with the American Red Cross Blood Services between January 1, 2006, and December 31, 2007, were analyzed.

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Background: Since 2004, several reported transfusion transmissions of variant Creutzfeldt-Jakob disease (vCJD) in the United Kingdom have reawakened concerns about the possible risk of similar transmissions of nonvariant or classic forms of CJD.

Study Design And Methods: Patients with a CJD diagnosis and a history of donating blood were reported to the study coordinator. Through review of blood distribution and hospital records, the recipients of blood components from these donors were identified.

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Background: Since its introduction into North America in 1999, West Nile virus (WNV) has spread rapidly across United States (US).

Objective: To genetically analyze WNV isolates from US blood donors during 2002-2005.

Study Design: Full-length nucleotide (NT) sequences of WNV isolates from 23 US volunteer blood donors of different geographic areas from 2002 to 2005 were determined and analyzed.

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Background: A large number of blood donors are deferred each year and many of the temporarily deferred donors do not return to donate blood. This study analyzed actual deferral and return donation data from the American Red Cross to further assess the impact of donor deferral on donor availability.

Study Design And Methods: Voluntary blood donors who presented between 2001 and 2006 were included in this study.

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Background: In certain circumstances, there is no method for estimating incidence based on testing results on a single blood sample from first-time blood donors, severely limiting the ability to assess the residual risk of blood-borne infections among this donor subpopulation.

Study Design And Methods: Incidence rates were estimated for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) among first-time donors using the formula (P(2) - P(1))/D, where P(1) is the prevalence among blood donations from first-time donors of the minimum eligible ages for donation, P(2) is the prevalence among donations from first-time donors of an older age group, and D is the age difference (in years) between the older and younger donor groups.

Results: Estimating incidence among first-time donors using the proposed method based on a single test for anti-HCV produced similar results to those based on HCV nucleic acid test (NAT) yield cases, by sex and in different periods.

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No transmission through transfusion has been reported for classic Creutzfeldt-Jakob disease (CJD). Moreover, a series of epidemiological surveillance, case-control, and look-back studies have provided no evidence of such transmission of CJD. Hence, the risk of such transfusion transmission of classic CJD remains theoretical.

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Background: The American Red Cross has been maintaining a research database of all blood donors. Such a database provides a unique opportunity for monitoring changes over time in donor and donation patterns.

Study Design And Methods: Changes in age distribution among blood donors were analyzed through comparison of the volunteer donor population in 1996, 1999, 2002, and 2005, before and after adjustment for demographic changes of the general population in the United States.

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Background: In South Africa, human immunodeficiency virus-1 (HIV-1) infection correlates with herpes simplex virus-2 (HSV-2; genital herpes) seropositivity in genitourinary disease clinic attendees. HSV-2 infection may be a marker for risk behavior and/or directly facilitate HIV-1 transmission. The rate of HSV-2 infection in HIV-infected South African and US blood donations was assessed, and whether the infections were correlated in donors screened and found negative for high-risk behavior by predonation interview was questioned.

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Background: The Uniform Donor History Questionnaire (UDHQ) was implemented across the American Red Cross Blood Services in 2005. This study assessed the potential impact of changes inherent in UDHQ implementation on deferral and on prevalence of infectious disease markers among donated units.

Study Design And Methods: Deferral and donation records were extracted and analyzed for the period of April 1, 2005, to September 30, 2005, after the implementation of the UDHQ and for the same period in the previous year.

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Background: The American Red Cross initiated systemwide bacterial testing of all apheresis platelet (PLT) collections in March 2004, yet continues to receive reports of septic reactions after transfusion of screened components.

Study Design And Methods: The rates of confirmed bacterial contamination of apheresis PLT collections detected by prospective quality control (QC) testing, and by surveillance of reported septic reactions to screened-negative apheresis PLTs, were analyzed according to the technology utilized for collection.

Results: Between March 1, 2004, and May 31, 2006, bacterial culture testing was performed on 1,004,206 donations; of these, 186 (1:5,399) had confirmed-positive culture results.

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Background: Starting in 1999, the West Nile virus (WNV) epidemic represents the largest outbreak of arboviral encephalitis ever recorded in the U.S. The effective means to determine an infection are detection of viral nucleic acid and/or viral specific immunoglobulin, IgM and/or IgG.

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Background: Routine quality control (QC) testing for bacterial contamination in apheresis platelet (PLT) products was implemented in all 36 regional blood centers of the American Red Cross in March 2004.

Study Design And Methods: PLT samples were cultured under aerobic conditions until the end of the product shelf life or when a positive reaction was indicated. To confirm the initial positive reaction, a new sample was taken from the unit for reculturing.

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Background: West Nile virus first appeared in the United States in 1999 and has since spread throughout the contiguous states, resulting in thousands of cases of disease. By 2002, it was clear that the virus could be transmitted by blood transfusion, and by the middle of 2003, essentially all blood donations were being tested for West Nile virus RNA with the use of investigational nucleic acid amplification tests; testing was performed on individual samples or on "minipools" of up to 16 donations.

Methods: We analyzed data from the West Nile virus testing program of the American Red Cross for 2003 and 2004 to identify geographic and temporal trends.

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Background: Newly implemented NAT has been shown to be able to effectively identify HCV-positive blood donated during the preseroconversion period.

Study Design And Methods: EDTA-plasma pools of 24 donations were tested using an HIV-1/HCV multiplex NAT under an FDA-approved IND application. Samples in a positive pool were retested individually.

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Background: An HIV-1 and HCV NAT blood screening assay (Procleix HIV-1/HCV, Gen-Probe, Inc.) simultaneously detecting HIV-1 and HCV RNA) has been implemented. Donor plasma samples reactive in the Procleix HIV-1/HCV assay are tested with the HIV-1 and HCV discriminatory assays to resolve whether HIV-1 RNA, HCV RNA, or both are present.

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