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Infectious agents for which donated blood is screened in the United States

Infectious agents for which donated blood is screened in the United States
Infectious organism Test method used and comments on testing
Babesia microti (babesiosis) Units collected in high-risk regions of the United States undergo nucleic acid minipool testing for parasite nucleic acid.
Cytomegalovirus Selected units may be tested to establish a CMV-negative inventory for at-risk recipients, using an immunoassay for anti-CMV antibodies.*
Hepatitis B virus All units; immunoassay for HBsAg and HBc antibody and nucleic acid minipool testing for viral DNA.
Hepatitis C virus All units; immunoassay for antibody and nucleic acid minipool testing for viral RNA.
HIV-1 and 2 All units; immunoassay for antibody (with further confirmation testing if reactive) and nucleic acid minipool testing for viral RNA.
HTLV-I and II All units; immunoassay for antibody (with further confirmation testing if reactive).
Treponema pallidum (syphilis) All units; usually immunoassay for T. pallidum-specific antibody; may also perform an additional non-treponemal immunoassay on reactive samples to help determine when infection occurred.
Trypanosoma cruzi (Chagas disease) The initial donation from all donors is screened by immunoassay for antibody (with further confirmation testing if reactive). Repeat donations from previously-tested donors do not require retesting.
West Nile virus All units; nucleic acid minipool or individual donation testing for viral RNA.
Zika virus Previously all units, using nucleic acid minipool or individual donation testing for viral RNA; phased out in 2021 due to documented absence of ongoing risk.
Refer to UpToDate for a discussion of the laboratory testing of donated blood. In addition to this testing, platelets, which are stored at room temperature, also undergo bacterial testing, the details of which vary by institution. Additional donor screening, self-deferral, and in some cases pathogen inactivation processes are used to address the risks listed in the table as well as other infectious risks.

CMV: cytomegalovirus; HBc: hepatitis B core antigen; HBsAg: hepatitis B surface antigen; HIV: human immunodeficiency virus; HTLV: human T-lymphotropic virus.

* Refer to UpToDate text and table on risk of viral and bacterial infection from blood products for further details of CMV-reduced risk units.
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