Screening of selected male blood donors for p24 antigen of human immunodeficiency virus type 1

Article Abstract:

Although largely effective, blood screening to detect antibodies against human immunodeficiency virus, type 1, (HIV-1), which is associated with AIDS, fails to detect infected blood in some cases. This may be because the donor has become infected with the virus too recently for detectable levels of antibody production to have been reached. Thus, direct testing for the virus itself may yield more accurate results. This was investigated by screening 8,597 donated blood samples for p24, an antigen associated with HIV-1. The samples were collected as part of the Transfusion Safety Study, which investigates viral transmission in blood and blood products. Demographic information, including the ZIP code in which they lived, was available for these donors who were men between the ages of 18 and 44. The samples studied were from areas with a high prevalence of positive tests for HIV-1 antibodies. Results showed that the antibody prevalence was 1.54 percent, much higher than the overall prevalence in donated blood in the US, which is 0.012 percent. Thus, the samples did represent a high-risk population. Slightly more than 11 percent of these samples also contained the p24 antigen; none of the samples that tested negative for the HIV-1 antibody tested positive for p24. These results indicate that screening blood for p24 antigen would not provide useful information regarding donor infection status. It is likely that the antigen is present in blood only a few days or weeks after infection. The only group of people in whom p24-positivity precedes the appearance of detectable levels of HIV-1 antibodies in the blood are those paid for repeated plasma donations. Such donations can be made every second day, while blood can be donated only every two months. The importance of carefully evaluating blood repositories to improve the safety of transfusions is discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Testing, HIV infection, HIV infections, HIV (Viruses), HIV, Blood, Blood donors, Blood donation, HIV antibodies

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Long-term mortality after transfusion-associated non-A, non-B hepatitis

Article Abstract:

Transfusion-associated non-A, non-B hepatitis does not appear to increase the number of deaths overall but may increase deaths due to liver disease. Acute non-A, non-B infection is generally mild, but studies have indicated that more than half of the infected patients develop chronic hepatitis. A study of 1,552 blood transfusion recipients matched 568 subjects with transfusion-associated non-A, non-B hepatitis with 984 controls and monitored them for approximately 18 years. The percentage of deaths due to all causes was almost identical between infected and control subjects, and overall the frequency of death due to liver disease was low. However, among subjects with non-A, non-B hepatitis, 6.2% died of liver disease compared with 3.2% non-infected subjects. Of 28 subjects from both groups for whom liver disease was the main cause of death, 20 (71%) were heavy drinkers.

Patient outcomes, Mortality, Liver diseases, Hepatitis C

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Screening the blood supply for West Nile virus RNA by nucleic acid amplification testing

Article Abstract:

The yield and characteristics of positive donations and the incremental yield and safety of nuclei acid amplification tests of individual donations is reported. The results support the use of targeted nucleic acid amplification testing of individual donations in high-prevalence regions, a strategy that was implemented successfully in 2004.

Biological Product (except Diagnostic) Manufacturing, Drugs, Nucleic Acids, Analysis, RNA, West Nile virus

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