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- Title
ORIGINAL PAPER First report of human immunodeficiency virus transmission via an RNA-screened blood donation.
- Authors
Delwart, E. L.; Kalmin, N. D.; Jones, T. S.; Ladd, D. J.; Foley, B.; Tobler, L. H.; Tsui, R. C. P.; Busch, M. P.
- Abstract
Blood banks in the USA have recently introduced minipool nucleic acid amplification testing (MP-NAT) of blood products to reduce the transmission of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) by transfusions. However, MP-NAT is limited in its ability to detect preseroconversion samples with very low viral RNA loads. To determine whether a red blood cell unit, from an MP-NAT-negative donation, transmitted HIV when transfused to a patient, we compared the viral sequences from the blood donor and recipient. The implicated donation was also tested by commercially available NAT assays at a range of dilution factors to determine whether the infectious unit could have been detected using individual-donation NAT (ID-NAT). Phylogenetic linkage of HIV sequences in the blood donor and recipient confirmed the transmission of HIV by blood transfusion, the first such case identified since introduction of MP-NAT screening in 1999. Viral RNA was reliably detected by ID-NAT, but only inconsistently detected by MP-NAT. Even following the introduction of MP-NAT, a preseroconversion donation with a viral load of ≤ 150 copies of RNA/ml went undetected and resulted in an HIV transmission. Implementation of ID-NAT will further reduce such rare transmissions, but at a considerable cost per infectious unit interdicted.
- Publication
Vox Sanguinis, 2004, Vol 86, Issue 3, p171
- ISSN
0042-9007
- Publication type
Academic Journal
- DOI
10.1111/j.0042-9007.2004.00416.x