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 <or= 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.
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 <or= 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.
Authors: Thelma T Goncalez; Paula F Blatyta; Fernanda M Santos; Sandra Montebello; Sandra P D Esposti; Fatima N Hangai; Nanci A Salles; Alfredo Mendrone; Hong-Ha M Truong; Ester C Sabino; Willi McFarland Journal: Transfusion Date: 2015-02-03 Impact factor: 3.157
Authors: Mars Stone; John Bainbridge; Ana M Sanchez; Sheila M Keating; Andrea Pappas; Wes Rountree; Chris Todd; Sonia Bakkour; Mark Manak; Sheila A Peel; Robert W Coombs; Eric M Ramos; M Kathleen Shriver; Paul Contestable; Sangeetha Vijaysri Nair; David H Wilson; Martin Stengelin; Gary Murphy; Indira Hewlett; Thomas N Denny; Michael P Busch Journal: J Clin Microbiol Date: 2018-07-26 Impact factor: 5.948
Authors: Zhong-Min Ma; Mars Stone; Mike Piatak; Becky Schweighardt; Nancy L Haigwood; David Montefiori; Jeffrey D Lifson; Michael P Busch; Christopher J Miller Journal: J Virol Date: 2009-01-07 Impact factor: 5.103
Authors: Elizabeth C Moreno; Roberta Bruhn; Ester C Sabino; Eduarda Bolina-Santos; Carolina Miranda; Anna Barbara Carneiro-Proietti; Maria Esther Lopes; Cesar de Almeida-Neto; Paula Loureiro; Ligia Capuani; Pedro L Takecian; Brian Custer; Thelma T Gonçalez Journal: Hematol Transfus Cell Ther Date: 2019-02-18