Seroprevalence and determinants of diphtheria, tetanus and poliomyelitis antibodies among adults in Berlin, Germany.

The immunity levels against diphtheria, tetanus and poliomyelitis were investigated among blood donors (n = 2079) in Berlin. Of all participants, only 60% had full, long-term protection against diphtheria, 72% against tetanus, 87% against poliomyelitis type 1, 77% against poliomyelitis type 2 and 73% against type 3. There was a striking decrease of tetanus and diphtheria immunity levels by age. Immunity levels against tetanus were higher among males, whereas females were better protected against poliomyelitis. After adjusting for confounding effects in logistic regression diphtheria immunity in those aged <40 years was significantly higher in participants from East-Berlin, whereas the immunity levels against poliomyelitis were higher in West-Berlin. These differences reflect the different vaccination policies in East-Germany and West-Germany before 1989. There is a need to improve the immunity levels of the adult population in Berlin.

Complement activation during plasma production depends on the apheresis technique.

Elevated anaphylatoxin concentrations have been found in fresh frozen plasma packs produced by apheresis. The aim of this study was to investigate anaphylatoxin generation during apheresis production in relation to two frequently used techniques: employing either centrifugation alone or centrifugation with simultaneous filtration. The concentrations of C3a. C5a and sC5b-9 were measured in 50 plasmas after apheresis and before freezing generated by combined centrifugation and filtration and in 50 plasmas generated solely by centrifugation and in the corresponding 100 donors before apheresis. The median C3a concentration increased during apheresis by centrifugation alone from 62 (donor) to 380 micrograms L-1 (FFP pack) and during apheresis by combined centrifugation and filtration from 70 to 992 micrograms L-1. The median C5a concentration increased during apheresis by centrifugation alone from 0.38 to 0.83 microgram L-1 and during apheresis by combined centrifugation and filtration from 0.29 to 4.9 micrograms L-1. The soluble terminal complement complex increased only by combined centrifugation and filtration apheresis from 162 to 426 micrograms L-1. Complement activation during apheresis by combined centrifugation and filtration is more pronounced than that obtained by the centrifugation method alone. Changes in the construction or the materials used in the membrane-type separation units may reveal possibilities of prevention.

[Leukocyte depletion by in-line-filtration]. / Leukozytendepletion durch In-line-Filtration.

Leukocyte depletion was tested in 30 red cell concentrates (RCC) using a new 450-ml triple U blood-bag system (Optipac, Baxter) with an integrated polyester filter (Sepacell R 2000). Centrifugation at 3,600 rpm was well tolerated by all filters. RCC were filtered 48 h after preparation (mean time 25-30 min). Filtration loss of red blood cells was about 7%. Prefiltration leukocyte concentration averaged 3 x 10(9) leukocytes/l (Coulter). After filtration 6 x 10(5) leukocytes/l (median) were counted in the Nageotte chamber (NC). 1.5 x 10(5)/RCC leukozytes (WBC) per filtered RCC were calculated (median). 29/30 (97%) RCC contained less than 5 x 10(6) WBC, in 4 cases no WBC were detectable in the NC, but 6.62 x 10(6) WBC remained in 1 RCC. The rate of hemolysis (8/30) averaged 0.4% on day 42. Handling was easy, allowing routine use. Quality controls are necessary.

HIV prevalence in blood donors in urban and in rural areas of the Federal Republic of Germany.

HIV infection rates in blood donors from the FRG were compared with the prevalence in donors from Berlin to obtain information on the HIV infections in donors of rural versus urban origin. The HIV prevalences decrease similarly in the first years of testing, although on different levels. They are lower in rural areas by a factor of 15 in the first year and of 10 thereafter. The modes of infectivity in both groups are similar although drug abuse seems to be more frequent amongst infected donors of urban areas. Ninety percent of the infected donors are either persons at risk or sexual partners of risk persons. During the observed time period there seems to be a trend from homo-/bisexuality and i.v. drug abuse to heterosexual contacts with persons at risk as the mode of infection. In conjunction with the stabile low and constant rates of infection for the last two years, these data indicate that the risk of HIV infection by blood transfusion is reduced to an acceptable minimum even in urban areas.

Risk of HIV infection from former blood donations of donors found to be HIV antibody-positive in blood bank routine testing. "Look-back" study in German Red Cross Blood Banks in the FRG.

Recipients of blood given by 52 repeat blood donors found to be positive by Western blot analysis for anti-HIV from April 1985 to December 1987, among a total of 1.6 million blood donors in the German Red Cross Blood Banks in the FRG, were investigated. Of 149 recipients identified, 76 (51%) had died. Ten recipients refused to be tested. Of those recipients who were tested at least 5 months after transfusion, 46 were HIV antibody negative and 17 were Western blot-positive. In 14 of the HIV antibody-positive recipients, transfusion was given during the period from 1982 to the begin of routine testing in 1985. Three recipients of HIV antibody-negative donations were subsequently identified as HIV positive. The blood had been donated a median of 3 months before HIV antibodies were detected in the donors. From a total of 3 million donations since testing has been introduced, the risk of HIV transmission in tested blood is 1:1 million in our donor population where the HIV antibody prevalence (in Western blot) is about 1 per 100,000 donations/donors.

[Epidemiology of HIV in blood donors in West Germany]. / Epidemiologie des HIV bei Blutspendern in der Bundesrepublik Deutschland.

Of a total of 5.6 million blood donations by 1.6 million German Red Cross donors between July, 1985 and December, 1987 tested for HIV antibodies 210 were found to be positive in at least one Western blot. Calculated per quarter, the prevalence (for first-time donors) of 10 per 100,000 in 1985 decreased to 4 per 100,000 in 1986, while the incidence (for multiple donors) was a constant 2 per 100,000 for each quarter in 1987. This indicates that new HIV infections were rare in blood donors and there was no exponential increase. Further analysis revealed that over 90% of those with confirmed Western blot positive results were members of risk groups or their direct contacts. The age and sex distribution conformed to the known pattern for AIDS cases in the Federal Republic of Germany. The data demonstrate that there is at present no indication of a rapid spread of HIV infections transmitted heterosexually among blood donors.

[Prevalence of HIV antibodies in blood donors in the West Germany and West Berlin]. / Prävalenz von HIV-Antikörpern bei Blutspendern in der Bundesrepublik Deutschland und in West-Berlin.

Since 1985 all donor blood in the Federal Republic of Germany (FRG) and West Berlin (WB) have been routinely tested for HIV antibodies. The blood donor services of the German and Bavarian Red Cross have pooled their anti-HIV test data for the first year of operation (July 1985-June 1986) to obtain information on the prevalence of HIV antibodies in blood donors and in donated blood. Of 2.27 million units of blood, donated by 1.33 million donors, 218 were anti-HIV positive in the Western Blot Test, i.e. a prevalence rate of 10 per 100,000 donors. The prevalence was, as expected, higher in males than females. During the test period the anti-HIV prevalence fell, both as a total and in all subpopulations. In the second quarter of 1986 it had decreased to 6 per 100,000 donated units.