First report of human immunodeficiency virus transmission via an RNA-screened blood donation |
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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 |
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Affiliation: | University of California, San Francisco, CA, USA. |
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Abstract: | BACKGROUND AND OBJECTIVES: 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. MATERIALS AND METHODS: 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). RESULTS: 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. CONCLUSIONS: Even following the introduction of MP-NAT, a preseroconversion donation with a viral load of
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Keywords: | blood donation HIV nucleic acid testing transfusion |
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