Background: The majority of the blood supply, in the United States, is currently being screened for both the hepatitis C virus (HCV) and HIV by NAT under investigational new drug applications with the Food and Drug Administration. Prior to implementation of experimental H1V NAT testing, a frequent platelet donor tested H1V p24 antigen (Ag) positive (confirmed by neutralization) and HIV antibody (Ab) negative. Two platelet donations were made by this donor 4 and 11 days prior to the index donation. The two recipients of the day -4 double plateletpheresis donation became infected with HIV. The sole recipient of the day -11 platelet donation expired, from his primary disease, prior to testing for HIV seroconversion. Stored samples from the donations were retrospectively tested to determine if HIV pooled donor sample NAT would have prevented these "window period" transmissions. Study Design: HIV NAT was performed on frozen samples (originally collected for HCV RNA NAT) from the three HIV antibody negative donations. NAT was performed on a pool of 24 (sample plus 23 known negatives) and on individual samples by RNA polymerase chain reaction. Results: The index donation (HIV p24 Ag positive, HIV Ab negative) was positive in both pooled and individual (164,057 copies/ mL) NAT for HIV RNA. The day -4 donation (HIV p24 Ag negative, HIV Ab negative) was positive in pooled and individual (1,984 copies/mL) NAT. The day -11 donation (HIV p24 Ag negative, HIV Ab negative) was negative in both pooled and individual (< 400 copies/mL) NAT. Conclusion: Pooled HIV NAT would have prevented HIV transmissions from plateletphereses collected four days prior to HIV p24 antigen .seroconversion. No conclusion can be made concerning the infectivity of the donation made eleven days prior to HIV p24 Ag seroconversion, due to the recipient's early demise.
|Original language||English (US)|
|Issue number||11 PART I|
|State||Published - 2000|
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