Clinical implications of positive tests for antibodies to human immunodeficiency virus type 1 in asymptomatic blood donors

Article Abstract:

Issues concerning the purity of the supply of blood continue to be a concern to the community. When 693,000 blood donors were screened for the AIDS virus HIV-1 (human immunodeficiency virus type 1), 284 tested positively on one of two different screening systems. In many cases the two tests gave conflicting results, meaning that one test did not detect the presence of the virus, or else indicated the virus when it was in fact absent. To monitor the clinical significance of this discrepancy, 156 donors with a positive Western blot assay and 80 donors with positive immunoassay and negative or indeterminate Western blot result were followed at 6-month intervals for an average of 28 months. Positive Western blot results were more likely to occur in Afro-Americans, men who were first time donors, people who had previously had a venereal disease and people with enlarged lymph nodes. Approximately 17 percent of these patients showed a further development of their infection toward a fully developed case of AIDS. No patients who tested positive by immunoassay but were not positive by Western blot have shown further evidence of AIDS during the period, and probably present no risk of transmitting HIV. As of December 1988, 79,823 cases of AIDS had been reported, of which 3 percent were as the result of contaminated blood products. Screening of blood donors resulted in 25,000 units of donated blood being discarded in the first year of screening, many on the basis of a single unsubstantiated test result. The results of this study may effect changes to the donation criteria, which could save a substantial number of these discarded donations, and also allow physicians to better counsel individuals who have received a positive test result.

Research, Case studies, Blood collection and preservation, AIDS (Disease), Blood banks, Immunoblotting

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Prevalence of human immunodeficiency virus type 1 p24 antigen in U.S. blood donors - an assessment of the efficacy of testing in donor screening

Article Abstract:

Although largely effective, blood screening to detect antibodies against human immunodeficiency virus, type 1 (HIV-1), the virus associated with AIDS, fails to detect infected blood in some cases. The resulting risk of HIV transmission ranges from 1 in 38,000 to 1 in 153,000. This may be due to donor infection that occurs too recently for detectable levels of antibody to have appeared. Direct screening for the virus, rather than the antibody against the virus, may reduce the risk of transmission. This was evaluated by testing 515,494 samples of donated blood for the presence of the p24 antigen, a protein associated with HIV-1 that appears early in the course of infection. The samples were obtained at 13 blood centers throughout the US; those that tested positive for p24 antigen were retested and then shipped to a central laboratory for further evaluation. At the central laboratory, the blood was also tested for HIV-1 antibodies. Results showed that 225 (18 percent) of the samples repeatedly tested positive for p24 antigen; of these, only five samples contained p24 antigen as confirmed by neutralization assay (one of the methods of identifying the antigen). These samples also tested positive for HIV-1 antibody and the virus. However, three of these donors would have been excluded because of the presence of other infectious diseases. Two of the donors were in high-risk categories and should not have donated blood. The remaining 220 samples did not test positive for p24 antigen, HIV-1 antibody, or for the virus itself. The results indicate that routine testing for this antigen in donated blood is not warranted. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Diagnosis, Measurement, HIV infection, HIV infections, HIV (Viruses), HIV, Blood

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The incidence of transfusion-associated hepatitis G virus infection and its relation to liver disease

Article Abstract:

Some blood donors may be infected with the hepatitis G virus (HGV) and could pass it on. In a study of 500 blood donors and 357 transfusion recipients, 7 (1.4%) of the blood donors tested positive for HGV. Seventy-nine transfusion recipients developed transfusion-associated non-A, non-B hepatitis and 80% tested positive for the hepatitis C virus (HCV). Ten percent also tested positive for HGV. However, their hepatitis was no more severe than the transplant recipients infected with HCV only. Three transplant recipients were infected with HGV alone, and none developed severe hepatitis.

Health aspects, Blood transfusion, Hepatitis viruses

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