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HIV transmissions from a window-period platelet donation.
P M Kopko1, L P Fernando, E N Bonney
1Sacramento Medical Foundation Blood Centers, 1625 Stockton Blvd, Sacramento, CA 95186-7089, USA.
American Journal of Clinical Pathology
|October 17, 2001
Summary
Investigational HIV RNA testing in blood donations can prevent infections. A platelet donor who tested negative before HIV RNA testing transmitted the virus, highlighting the need for this advanced screening.
Area of Science:
- Infectious Diseases
- Blood Transfusion Safety
- Virology
Background:
- Blood donation centers are implementing investigational testing for Human Immunodeficiency Virus (HIV) RNA using pooled nucleic acid testing (NAT).
- Early HIV infection detection is crucial for preventing transfusion-transmitted infections.
Observation:
- A frequent platelet donor tested positive for HIV p24 antigen but negative for antibodies prior to the widespread implementation of NAT.
- This donor made two platelet donations shortly before his HIV seroconversion was confirmed.
Findings:
- Retrospective analysis of stored samples revealed HIV RNA in the day -4 platelet donation but not in the day -11 donation.
- Two recipients of platelets from the day -4 donation subsequently tested positive for HIV RNA and p24 antigen.
Implications:
- This case demonstrates the potential for transfusion-transmitted HIV from donors in the very early stages of seroconversion, undetectable by antibody or p24 antigen tests alone.
- The implementation of HIV RNA nucleic acid testing (NAT) in blood screening could have prevented these transmissions.
- Enhanced screening protocols are vital for maintaining the safety of the blood supply against emerging infectious threats.