Human immunodeficiency virus infection and indeterminate Western blot patterns: prospective studies in a low prevalence population

Article Abstract:

There are several blood tests that detect the presence of antibodies to HIV, the virus associated with AIDS. A person who tests positive (has antibodies to HIV) is likely to be infected with the virus. One of two such tests is the Western blot (WB), which is often used to confirm a positive ELISA test (enzyme-linked immunoabsorbent assay; a relatively inexpensive method for detecting an antibody). However, the more conclusive WB test can sometimes have 'indeterminate' results, meaning that it isn't positive, according to established criteria, but isn't negative either. As many as 15 percent of WB tests may be indeterminate, and the individuals tested may be given little explanation to help them understand what this result means. To determine exactly what it does mean, a group of blood donors who had indeterminate WB tests were followed for up to two years. In a group of 387 blood donors, 98 had an indeterminate WB test. After a 12 month follow-up, only one of the 98 individuals had developed a positive WB test, indicating conversion to HIV infection. Fifteen had become WB negative. In addition, all 98 experienced no signs or symptoms associated with HIV infection, such as lymphadenopathy (enlarged lymph glands), decreased numbers of certain lymphocytes (a type of white blood cell), or increased levels of IgG (an antibody). There was also no sign of HIV infection in their mononuclear cells, a blood cell that is often infected by the virus. Some of the individuals with an indeterminate WB test did admit to having one or more risk factors for HIV infection, yet had no evidence of HIV infection. Therefore, the presence of risk factors should not be used to turn an indeterminate WB test into a diagnosis of HIV infection. Individuals with a persistent indeterminate WB test, and no risk factors for or symptoms of HIV infection, may be told that they are probably not infected with HIV. Those with risk factors for HIV infection should receive follow-up testing. Individuals whose WB tests reveal antibodies to the p24 or envelope proteins of the virus should also be monitored. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Diagnosis, HIV seropositivity, HIV positive, Western immunoblotting, Western blot

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Transmission of human T-lymphotropic virus types I and II by blood transfusion: a retrospective study of recipients of blood components (1983 through 1988)

Article Abstract:

Blood transfusions are often a means of transmitting viruses, such as those that cause AIDS and hepatitis. Two closely related viruses, human T-lymphotropic virus type I and type II, are associated with some unusual cancers and muscle diseases, and have been found to be transmissible through blood transfusion. In the very recent past, tests were developed that can detect HTLV-I/II, thus reducing the likelihood that they will be transmitted by future transfusions of infected blood. A study was performed of existing samples of blood that were transfused before these tests became available. The purposes of this analysis were to determine the rate of HTLV-I/II infection in donors, to trace the recipients of those units of blood, and to determine their rate of infection. A group of 133 people who had received blood infected with HTLV-I/II were tested, and 17 were confirmed as having developed detectable levels of the virus, yielding a 12.8 percent rate of effective transmission. All of the infected recipients were found to have received blood products containing cells, such as red blood cells or platelets, rather than only plasma (the liquid component of blood that does not contain any blood cells). The older the units of blood the patients had received, the less likely they were to develop HTLV-I/II infection. Blood can be stored for several weeks before being transfused, and no cases of infection were found among people who had received contaminated blood that had been stored for longer than nine days. In many cases, the people who had donated the infected blood were found to have received blood themselves, confirming the importance of blood transfusion as a risk factor for HTLV-I/II infection. When blood donors are found to be infected with HTLV-I/II at the time of donation, a ''lookback'' should be done at recipients of any earlier units of blood these people might have donated to determine if the previous recipients developed infection. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Disease transmission, HTLV-I infections, HTLV-II infections, Blood transfusion, Blood-borne diseases, Bloodborne diseases, Blood donors, Blood donation, HTLV-I (Virus), HTLV-II (Virus)

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Detection of HIV-1 and HCV infections among antibody-negative blood donors by nucleic acid-amplification testing

Article Abstract:

It is estimated that nucleic acid screening has reduced the residual risk of transfusion-associated infection for both HIV-1 and HCV to about 1 in 2 million blood units from repeated donors. Minipool nucleic acid-amplification testing has helped prevent the transmission of approximately 5 HIV-1 infections and 56 HCV infections annually.

Science & research, Biological Product (except Diagnostic) Manufacturing, Drugs, Nucleic Acids, Research, Prevention

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