# Presentation: 696501

## Prevalence and risk relationships of tattoo, acupuncture and skin/body piercing histories among American Red Cross blood donors 

- Sharyn Orton, MSPH, PhD
- FDA, Regulatory Project Manager, Division of Blood Applications
- and
- Roger Dodd, PhD
- ARCNET Epidemiology Group
- American Red Cross Holland Laboratory, Rockville, MD

## ARC Donor History Question

- “In the past 12 months, have you had a tattoo,
- ear/body piercing, acupuncture, accidental
- needlestick, or come into contact with someone
- else’s blood?”
- 	Since 12/00, includes “or taken (snorted) cocaine or
-     any other street drug through your nose”.

## Objectives

- Prevalence
- Donor demographics
- Describe returning donors

## MACS Database

## Database

- Donations, donor demographics, infectious disease markers and deferrals
- For this analysis from 1/1/1998 through 9/30/2001
- Includes data from all 35+ ARC Blood Regions

## Prevalence of TAP Deferral

| Year | TAP | Of total deferrals | Total donations |
| --- | --- | --- | --- |
| 1998 | 18981 | 445592 (4.3%) | 6.4 million  |
| 1999 | 30677 | 571353 (5.4%) | 6.6 million  |
| 2000 | 28481 | 776866 (3.7%) | 6.8 million  |
| 2001 (thru 9/01) | 24421 | 877720 (2.8%) | 7.3 million  |
| Total | 102560 | 2671531 (3.8%) |  |

**27.1 million **

**Notes:**
1998 first year of complete data.
Total number of donors as a reference; deferrals are not included in donation unless a callback. (~.3%)

## Demographics of TAP deferred donors

| Year | Sex |  Age |
| --- | --- | --- |
| 1998 | Females: 58%
Males:    42% | Mean = 27 yrs
Median = 22 yrs |
| 1999 | Females: 57%
Males:    43% | No change |
| 2000 | Females: 56%
Males:    44% | No change |
|  2001* | Females: 56%
Males:    44% | No change |

## Returning TAP Deferred Donors

- 24024 donors returned (volunteer or directed)
- Of 102560
- Gave 55599 total donations
- Time between deferral and subsequent return
- Mean = 438 days
- Median = 365 days

**Notes:**
Total returning donors=24221 for 55898 donations; includes autologous; therapeutic, limited exposure, research.
There were 18422 tattoo deferrals by callback
      38 volunteer and one autologous donor (total of 40 pos markers) had a
      confirmed positive infectious disease marker at the time of donation 		21 anti-HCV
	7 HBsAg
	2 anti-HTLV
	10 FTA-ABS
	0 anti-HIV
No NAT positives

## Infectious Disease Markers

- At time of return donation
- 2 anti-HIV
- 0 anti-HCV
- 0 HBsAg
- 0 anti-HTLV
- 0 syphilis
- 123 anti-core

**Notes:**
Other miscellaneous:
No NAT positive, seronegatives
127 used CUE when they returned (127/24024=0.5%)
       Cue used in V WB donors between 1998 and 9/01: 54686 of 23262356
       donations = 0.2%)
Over same time period (confirmed markers in V WB donors):
   anti-HIV: 829/25,411,668 = 3/100,000K

## HIV infected donors*

- Donor 1
- Female, age 27
- Volunteer whole blood
- First-time donor, no other positive marker
- HIV + at return donation 364 days after TAP deferral

**Notes:**
* Both donors deferred prior to the addition of the “snorting drugs” to the question

## continued

- Donor 2
- Female, age 20
- Volunteer whole blood donor
- Repeat donor (x 4)
- No other positive markers
- HIV + at return donation 350 days after TAP deferral
- Deferral for low Hgb 5 months previously
- Last successful donation 19 months previously

## Comments

- Unable to assess impact of “snorting drugs” addition to the question because of short follow-up time since implementation
- No indication of incident or prevalent HBV or HCV infection
- Two donors HIV + at follow-up donation; relationship to TAP risk is unknown

**Notes:**
The age/sex of the two donors is consistent with the current epidemiology of HIV infection and heterosexual transmission.

## HCV NAT Interview Study

## Methods

- Anti-HCV negative, initially HCV RNA positive
- 3/1/99 – 12/31/2001
- 653 invited to participate
- 230 enrolled
- 39 true HCV NAT positive
- 191 false positive controls
- Additional samples and an extensive survey questionnaire

## Questions

- In the 6 months prior to donation have you:
- Been tattooed
- Had any part of your body pierced

## Results

- No donor reported any body piercing or acupuncture
- 4 donors reported tattooing
- 3 cases; 1 control
- 2 cases reporting tattooing also reported IDU

**Notes:**
P-value for tattooing = .02
IDU: p-value = .009 (OR=38; 3-331)
No risk p-value = .21 (OR=8; .1 – 645)

## Comments

- Preliminary data
- Small numbers
- No overwhelming evidence of HCV transmission by tattoo

**Notes:**
P-value for tattooing = .02
IDU: p-value = .009 (OR=38; 3-331)
No risk p-value = .21 (OR=8; .1 – 645)