International forum: Saudi Arabia. Donor screening for HTLV-I in Saudi Arabia: is it cost effective?

After screening over 100,000 blood donations for the presence of anti-HTLV-I antibodies, a final prevalence of 0.0038% was established in a multinational donor population. Among 38,201 donations by Saudi Arabian donors, the prevalence was found to be 0.0052%. Fifty-eight donors were found to be repeat reactive in the EIA screen test, but only 6.9% of these (n = 4) were truly infected with HTLV-I as judged by the Western blot result. These results indicate that Saudi Arabia is non-endemic for HTLV-I as well as HTLV-II. The cost effectiveness of screening for HTLV-I in healthy blood donors from this area is highly questionable. Calculations point to a final risk of a case of post-transfusion HTLV-I associated disease of approximately one per 100 years at the current level of activity.