The 4-Year Experience with Implementation and Routine Use of Pathogen Reduction in a Brazilian Hospital.

(1) Background: We reviewed the logistics of the implementation of pathogen reduction (PR) using the INTERCEPT Blood System™ for platelets and the experience with routine use and clinical outcomes in the patient population at the Sírio-Libanês Hospital of São Paulo, Brazil. (2) Methods: Platelet concentrate (PC), including pathogen reduced (PR-PC) production, inventory management, discard rates, blood utilization, and clinical outcomes were analyzed over the 40 months before and after PR implementation. Age distribution and wastage rates were compared over the 10 months before and after approval for PR-PC to be stored for up to seven days. (3) Results: A 100% PR-PC inventory was achieved by increasing double apheresis collections and production of double doses using pools of two single apheresis units. Discard rates decreased from 6% to 3% after PR implementation and further decreased to 1.2% after seven-day storage extension for PR-PCs. The blood utilization remained stable, with no increase in component utilization. A significant decrease in adverse transfusion events was observed after the PR implementation. (4) Conclusion: Our experience demonstrates the feasibility for Brazilian blood centers to achieve a 100% PR-PC inventory. All patients at our hospital received PR-PC and showed no increase in blood component utilization and decreased rates of adverse transfusion reactions.

Anti-A and SARS-CoV-2: an intriguing association.

BACKGROUND: Blood groups and anti-A isohemagglutinin may be involved in susceptibility to SARS-CoV-2 infection. MATERIALS AND METHODS: We retrospectively studied 268 COVID-19 convalescent plasma donors and 162 COVID-19 inpatients (total 430 subjects, confirmed by RT-PCR) and 2,212 healthy volunteer first-time blood donors as a control group. These were further divided into two groups: those with anti-A (blood types O and B) and those without it (types A and AB). Titres of nucleoproteins, and neutralizing SARS-CoV-2 antibody were measured in the convalescent plasma donors and inpatients. Multivariate logistic regression and non-parametric tests were applied. RESULTS: Persons having types O or B showed less infection prevalence than those of types A or AB (OR = 0·62, 95% CI 0·50-0·78; P < 0·001), but there was no difference when COVID-19 inpatients were analysed. Immunoglobulins M, G and A were lower in COVID-19 subjects of types O or B group than those of A or AB (0·16 vs. 0·19; P = 0·03, 2·11 vs. 2·55; P = 0·02, 0·23 vs. 0·32; P = 0·03, respectively). CONCLUSION: In this retrospective cohort, COVID-19 individuals were less likely to belong to blood types O and B, and also had lower SARS-CoV-2 antibody titres than A and AB individuals. COVID-19 severity did not associate with the blood groups.

Anti-A and anti-A,B monoclonal antisera with high titers favor the detection of A weak phenotypes.

OBJECTIVES: This study aimed to evaluate the reactivity and the titers of commercial anti-A and anti-A,B antisera in the detection of A weak antigen expression in human red blood cells. BACKGROUND: Commercial monoclonal antisera for ABO phenotyping are useful reagents allowing the identification of the four main ABO phenotypes (A, B, AB, and O). However, the reactivity of these commercial reagents can not be evident when the A or B antigens are weakly expressed, and these antisera have low titers. METHODS/MATERIALS: Six samples from blood donors and five samples from patients with ABO forward and reverse discrepant phenotyping were evaluated. The ABO phenotyping was carried out with different commercial monoclonal anti-A and anti-A,B antisera under different temperatures, using test tubes and gel column agglutination. RESULTS: Monoclonal anti-A antisera with titers less than 256 and anti-A,B with titers less than 128 failed to detect the weak expression of A antigen in 73% and 67% of the A weak phenotypes, respectively. Titres equal to or higher than 2048 (anti-A) and 1024 (anti-A,B) showed better reactivity, independent of the cell clone. CONCLUSION: Our data indicate that anti-A and anti-A,B antisera with high titers give better reactivity with red blood cells carrying A weak antigen expression.

Hierarchical assessment of host factors influencing the spontaneous resolution of hepatitis C infection.

BACKGROUND: Hepatitis C virus (HCV) infection is associated with chronic liver disease, resulting in cirrhosis and hepatocellular carcinoma. Approximately 20% of HCV infections are spontaneously resolved. Here, we assessed the hierarchical relevance of host factors contributing to viral clearance. METHODS: DNA samples from 40 resolved infections and 40 chronic HCV patients paired by age were analyzed. Bivariate analysis was performed to rank the importance of each contributing factor in spontaneous HCV clearance. RESULTS: Interestingly, 63.6% of patients with resolved infections exhibited the protective genotype CC for SNP rs12979860. Additionally, 59.3% of patients with resolved infections displayed the protective genotype TT/TT for SNP ss469415590. Moreover, a ranking of clearance factors was estimated. In order of importance, the IL28B CC genotype (OR 0.197, 95% CI 0.072-0.541) followed by the INFL4 TT/TT genotype (OR 0.237, 95% CI 0.083-0.679), and female gender (OR 0.394, 95% CI 0.159-0.977) were the main predictors for clearance of HCV infection. CONCLUSIONS: HCV clearance is multifactorial and the contributing factors display a hierarchical order. Identifying all elements playing role in HCV clearance is of the most importance for HCV-related disease management. Dissecting the relevance of each contributing factor will certainly improve our understanding of the pathogenesis of HCV infection.

Detecção dos anticorpos regulares abo maternos em recém-nascidos pelo método de tipagem sangüínea reversa estendida até fase de antiglobulina humana / Detection of the mother's abo regulars antibodies in newborns by the reverse blood typing

Neste estudo foram definidos os índices de detecção dos anticorpos regulares ABO maternos em recém-nascidos pelo método de tipagem sangüínea reversa estendida até fase de antiglobulina humana (TRAGH) e a relação destes resultados com os achados de outras metodologias envolvidas no diagnóstico da incompatibilidade materno-fetal pelo sistema ABO (IABO). Foram colhidasamostras sangüíneas para análise imuno-hematológica de 38 recém-nascidos com tipo sangüíneo A ou B, apresentando até 30 dias de vida (sem conhecimento prévio dos fenótipos ABO maternos) e realização dos testes de tipagem ABO direta, TRAGH, Coombs direto e eluato-LUI, visando detectar anti-A e/ou anti-B. Os resultados demonstraram que a TRAGH efetuou a detecção dos anticorpos regulares ABO maternos na maioria das amostras analisadas nas quais foram confirmados os casos de IABO (09 de 15 amostras), constituindo-se, mediante a análise conjunta com os demais dados imuno-hematológicos, em um útil parâmetro laboratorial na adequação imunológica do hemocomponente ao receptor ena confirmação diagnóstica de IABO.

In this study were defined the exponents of the detection of mother’s ABO regulars antibodies in newborns by the reverse blood typing extend up to stage of the antihuman globulin method (RTAGH) and the relacion this results with the faind other methods include in the diagnosis of the ABO maternal-fetal incompatibility (IABO). Samples of blood were picked for immunohematology analysis from 38 newborns with the blood type A our B , with until 30 days of life ( without previous knowing of the ABO mother’s types) and make of the ABO typing direct, RTAGH, Coombs direct and elution by freezing tests, purposing the detection of the anti-A and/our anti-B. The results demonstrate with the RTAGH maked the detection of the mother’s ABO regulars antibodies in the most samples analyses with the were confirmated the cases of the IABO (09 of 15 samples), constitute, trough the completeness analyse with too much tests immunohematology, in the useful laboratory information in the imunology adjust of the hemocomponent to the pacient and in the diagnosis of IABO confirmation.

Three cases of infection with hepatitis C virus genotype 5 among Brazilian hepatitis patients.

During the course of routine genotyping of hepatitis C virus isolates by 5' noncoding region sequencing, three samples were found to bear genotype 5-specific nucleotides. A serotyping method was subsequently applied and confirmed the finding. This is the first report of the occurrence of genotype 5 in Brazil.