Publications by authors named "Roberta Bruhn"

Background: General vaccination rates have been falling globally despite unequivocal health benefits. Noncompliance can result from access barriers and/or hesitant attitudes. Few studies have investigated the prevalence and determinants of noncompliance with COVID-19 vaccination in blood donors.

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HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a progressive demyelinating disease of the spinal cord due to chronic inflammation. Hallmarks of disease pathology include dysfunctional anti-viral responses and the infiltration of HTLV-1-infected CD4+ T cells and HTLV-1-specific CD8+ T cells in the central nervous system. HAM/TSP individuals exhibit CD4+ and CD8+ T cells with elevated co-expression of multiple inhibitory immune checkpoint proteins (ICPs), but ICP blockade strategies can only partially restore CD8+ T-cell effector function.

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  • Cardiometabolic diseases can worsen COVID-19 outcomes, and this study aimed to see if variability in related health indicators affects hospitalizations and long-term symptoms (PCC) in generally healthy individuals.
  • The study involved 3,344 blood donors whose health data was analyzed over several years and found that higher variability in body mass index (BMI) was linked to increased hospitalization and PCC risk, while blood pressure and cholesterol variability did not show a significant relationship.
  • The findings suggest that maintaining consistent BMI could be important for reducing COVID-19 severity and associated long-term effects.
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  • Long COVID is a complex condition affecting about 12% of COVID-19 survivors, with various symptoms and no widely accepted definition, pushing researchers to study its immune profile.
  • A survey of over 33,000 blood donors revealed that higher levels of anti-nucleocapsid antibodies are linked to an increased risk of long COVID, while higher anti-spike IgG levels can reduce that risk.
  • The study identified four clinical subphenotypes—ranging from neurological to multi-systemic symptoms—suggesting that different immune responses may contribute to varied long COVID experiences.
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  • * A study involving 142,599 blood donors established a new, lower threshold for detecting past infections using the Ortho VITROS Anti-SARS-CoV-2 Total-N Antibody assay, which boosted detection sensitivity while keeping specificity above 98%.
  • * The updated test showed a high sensitivity of 98.1% for unvaccinated individuals and 95.6% for those who were vaccinated, though sensitivity was influenced by factors like the virus variant, donor age,
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Background: Studies preceding the COVID-19 pandemic found that slower time-to-return was associated with first-time, deferred, and mobile drive blood donors. How donor return dynamics changed during the COVID-19 pandemic is not well understood.

Methods: We analyzed visits by whole blood donors from 2017 to 2022 in South Africa (SA) and the United States (US) stratified by mobile and fixed environment, first-time and repeat donor status, and pre-COVID19 (before March 2020) and intra-COVID19.

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  • The study analyzed changes in blood donor demographics and infectious diseases before and during the COVID-19 pandemic using a large database of over 26 million donations.
  • Findings revealed an increase in donations from females, older individuals, and repeat donors during the pandemic, while the overall frequency of donations also rose among these groups.
  • The prevalence of HIV and HCV infections decreased during the pandemic, whereas HBV prevalence remained unchanged, prompting ongoing monitoring of infection rates in blood donors.
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  • Human retroviruses like HIV and HTLV-1 originate from simian viruses and can lead to serious diseases in humans, despite being less harmful to their natural hosts.
  • Research revealed that the human protein APOBEC3G (A3G) causes G-to-A mutations primarily in HTLV-1, while HTLV-2 and STLV-1 have mechanisms to resist these mutations.
  • The study found that the antisense proteins from these retroviruses interact differently with A3G, with HTLV-1 exploiting A3G to promote cell growth in a way tied to cancer development, while HTLV-2 and STLV-1 do not have this effect.
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Introduction: Cardiometabolic diseases are associated with greater COVID-19 severity; however, the influences of cardiometabolic health on SARS-CoV-2 infections after vaccination remain unclear. Our objective was to investigate the associations between temporal blood pressure and total cholesterol patterns and incident SARS-CoV-2 infections among those with serologic evidence of vaccination.

Methods: In this prospective cohort of blood donors, blood samples were collected in 2020-2021 and assayed for binding antibodies of SARS-CoV-2 nucleocapsid protein antibody seropositivity.

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  • The study looked into the safety of transfusing plasma or platelets that contain SARS-CoV-2 antibodies to hospitalized patients who do not have COVID-19, during different phases of the pandemic.
  • Researchers analyzed data from over 21,000 hospitalizations across pre-COVID, pre-vaccine, and post-vaccine periods to see if there were any changes in health outcomes related to transfusions.
  • The results indicated that there were no significant increases in thrombotic events, oxygen requirements, ICU stays, hospital mortality, or rehospitalizations due to plasma or platelet transfusions, regardless of the pandemic period.
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  • The study focused on assessing HIV risk behaviors in men who have sex with men (MSM) to evaluate their eligibility for blood donation based on individual risk assessments.
  • Conducted in eight U.S. cities, the research involved surveys and blood tests for HIV and tenofovir, a PrEP drug, among sexually active MSM aged 18-39.
  • Results showed that about 50% of the participants were not using PrEP, and many reported lower-risk sexual behaviors, suggesting that a significant portion could be eligible to donate blood based on their risk profiles.
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Background: HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP) is an incapacitating neuroinflammatory disorder for which no disease-modifying therapy is available, but corticosteroids provide some clinical benefit. Although HAM/TSP pathogenesis is not fully elucidated, older age, female sex and higher proviral load are established risk factors. We investigated systemic cytokines and a novel chronic inflammatory marker, GlycA, as possible biomarkers of immunopathogenesis and therapeutic response in HAM/TSP, and examined their interaction with established risk factors.

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Background: To inform public health policy, it is critical to monitor coronavirus disease 2019 vaccine effectiveness (VE), including against acquiring infection.

Methods: We estimated VE using self-reported vaccination in a retrospective cohort of repeat blood donors who donated during the first half of 2021, and we demonstrated a viable approach for monitoring VE via serological surveillance.

Results: Using Poisson regression, we estimated an overall VE of 88.

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Article Synopsis
  • A national serosurvey in the U.S., initiated with the CDC, aimed to determine the prevalence of SARS-CoV-2 infections and vaccinations among blood donors.
  • The study began in July 2020 and involved testing around 150,000 blood samples monthly, utilizing a collaborative effort among blood collection organizations, labs, and government partners.
  • Results were made publicly accessible through the CDC website, and the study adapted its methods as the pandemic progressed, showcasing the importance of blood donation testing and public-private partnerships during health emergencies.
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Background: In 2017, San Francisco's initiative to locally eliminate hepatitis C virus (HCV) as a public health threat, End Hep C SF, generated an estimate of city-wide HCV prevalence in 2015, but only incorporated limited information about population HCV treatment. Using additional data and updated methods, we aimed to update the 2015 estimate to 2019 and provide a more accurate estimate of the number of people with untreated, active HCV infection overall and in key subgroups-people who inject drugs (PWID), men who have sex with men (MSM), and low socioeconomic status transgender women (low SES TW).

Methods: Our estimates are based on triangulation of data from blood bank testing records, cross-sectional and longitudinal observational studies, and published literature.

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Background: Human T-Cell Lymphotropic Viruses (HTLV) type 1 and type 2 account for an estimated 5 to 10 million infections worldwide and are transmitted through breast feeding, sexual contacts and contaminated cellular blood components. HTLV-associated syndromes are considered as neglected diseases for which there are no vaccines or therapies available, making it particularly important to ensure the best possible diagnosis to enable proper counselling of infected persons and avoid secondary transmission. Although high quality antibody screening assays are available, currently available confirmatory tests are costly and have variable performance, with high rates of indeterminate and non-typable results reported in many regions of the world.

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Human T-cell lymphotropic virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) develops in 1-5% of HTLV-1-infected individuals. Previous studies by us and others have shown that the expression of negative immune checkpoint receptors (NCRs) is significantly increased on CD8 T cells in various chronic viral infections and are associated with poor anti-viral immunity. We have previously identified the differential expression of NCRs on CD8 T cells in blood from patients with HAM/TSP and in central nervous system (CNS) tissues of HTLV-1 infected humanized mice and defined the association with neurological complications.

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Background: Monitoring of transfusion-transmissible infections in the blood supply is essential for blood safety, as the donor population is not static, and changes in policy, donor behavior, or other factors could increase the risk of recipient infection. We assessed patterns of recently acquired HIV infection in US blood donors, including before and after the implementation of the 12-month deferral for men who have sex with men (MSM).

Study Design And Methods: A large convenience sample of donations from donors testing HIV-1 nucleic acid testing (NAT) and serology-reactive were further tested with the Sedia HIV-1 Limiting Antigen enzyme immunoassay.

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In 2015, the US Food and Drug Administration published revised guidance that recommended a change in blood donor deferral of men who have sex with men (MSM) from an indefinite to a 12-month deferral since the donor last had sex with a man. We assessed whether HIV incidence in first-time blood donors or associated transfusion risk increased. Donations in 4 major blood collection organizations were monitored for 15 months before and 2 years after implementation of the 12-month MSM deferral policy.

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Background: Characterisation of the dynamics of Zika virus persistence following acute infection is needed to inform blood donor and diagnostic testing policies and understand the natural history of Zika virus infection. We aimed to characterise the natural history, persistence, and clinical outcomes of Zika virus infection through a prospective study in initially asymptomatic Zika virus RNA-positive blood donors.

Methods: Zika virus-infected blood donors identified through Zika virus nucleic acid amplification test (NAAT) screening at three blood collection organisations in the USA were enrolled into a 1-year follow-up study, with blood and body fluid samples and detailed symptom data collected at up to seven visits.

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Purpose: Outpatients with hematologic disease often receive red cell transfusion to treat anemia and fatigue. The effect of transfusion on fatigue-related quality of life and how well this effect is sustained has not been quantified. The study aim was to describe the early and sustained impact over 4 weeks of red cells on patient-reported fatigue in outpatients age ≥ 50 receiving transfusion as routine clinical care.

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Background And Objectives: Comparison of two models for estimating residual transfusion transmission risk by NAT screened window period (WP) donations in South African repeat donors gave identical results for HIV but not for HBV. In order to understand discrepant HBV modelling outcomes, the values of input parameters in three HBV WP risk models were reviewed and subsequently applied to the same South African screening data generated by HBsAg PRISM and two NAT assays (Ultrio and Ultrio Plus). Two of the models were also compared using individual donation (ID)-NAT screening data from different geographical regions.

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Background: Recent publications have reported conflicting findings regarding associations of blood donor demographics and mortality of transfused patients. We hypothesized that the analysis of additional donor characteristics and consideration of alternative outcomes might provide insight into these disparate results.

Study Design And Methods: We analyzed data from a retrospective cohort of transfused patients from the Recipient Epidemiology and Donor Evaluation Study-III (REDS-III).

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