Bruce A. Lenes

Duration of time from onset of human immunodeficiency virus type 1 infectiousness to development of detectable antibody

Background: For persons newly infected with the human immunodeficiency virus type 1 (HIV‐1), the time from the onset of infectivity to the development of detectable HIV‐1 antibody is unknown. Persons who donate blood during this period account for nearly all instances of HIV‐1 transmission from HIV‐1 antibody‐screened blood transfusions.

Prevalence of Human Immunodeficiency Virus Type 1 p24 Antigen in U.S. Blood Donors — An Assessment of the Efficacy of Testing in Donor Screening

Abstract Background. We performed a multicenter study in 1989 to determine whether screening whole-blood donors for human immunodeficiency virus type 1 (HIV-1) p24 antigen would improve transfusion safety by identifying carriers of the virus who are seronegative for HIV-1 antibody. Methods. More than 500,000 donations were tested at 13 U.S. blood centers with test kits from two manufacturers. Units found repeatedly reactive were retested in a central laboratory; if the results were positive, they were confirmed by a neutralization assay. A subgroup of units was also tested for HIV-1 by the polymerase chain reaction. Selected donors confirmed or not confirmed as having p24 antigen were contacted for follow-up interviews to identify risk factors and undergo retesting for HIV-1 markers. Results. Positive tests for p24 antigen were confirmed by neutralization in five donors (0.001 percent of all donations tested), all of whom were also positive for HIV-1 antibody and HIV-1 by polymerase chain reaction. Three ...

Prospective Evaluation of a Patient with Trypanosoma cruzi Infection Transmitted by Transfusion

To the Editor: Trypanosoma cruzi, the etiologic agent of Chagas disease, is endemic in Latin America, with 16 million to 18 million people infected.1 The parasite is transmitted naturally by a triatome insect, but it can also be transmitted by blood transfusion. Despite recent studies in the United States that identified T. cruzi–seropositive blood donors,2,3 most of whom came from countries where the parasite is endemic, only three cases of transfusion-transmitted T. cruzi infection have been reported to date.3 In December 1997, during a research study, we identified a 60-year-old woman with multiple myeloma who was unintentionally transfused .xa0.xa0.

Screening of Selected Male Blood Donors for p24 Antigen of Human Immunodeficiency Virus Type 1

BACKGROUNDnThe p24 antigen of human immunodeficiency virus type 1 (HIV-1) is sometimes detected before antibody (anti-HIV-1) is detectable in the serum of recently infected persons. This has led to the consideration of p24-antigen testing for routine screening of blood donors.nnnMETHODSnTo estimate how many HIV-infected seronegative donors would be identified if p24-antigen screening was introduced, we tested selected donations from a repository of 200,000 serum samples from voluntary donors that was established in late 1984 and early 1985. The 8597 serum samples selected for p24-antigen screening were chosen because their donors had demographic characteristics known to be associated with a high prevalence of seropositivity.nnnRESULTSnThe prevalence of anti-HIV-1 antibodies in the 1984-1985 serum samples selected for p24-antigen screening was 1.54 percent--more than 100 times the 0.012 percent prevalence in present-day donations in the United States. The antigen was detected in 15 of 132 serum samples (11.4 percent) from donors who had already been confirmed as seropositive. No instance of confirmed positivity for p24 antigen was found among the 8465 seronegative serum samples.nnnCONCLUSIONSnThese data indicate that the yield of screening for p24 antigen in volunteer donors to identify HIV-1 carriers would be negligible. We therefore recommend against routine screening with currently available p24-antigen assays.

Seroprevalence of known and putative hepatitis markers inUnited States blood donors with ALT levels at least 120 IU per L

BACKGROUND: ALT testing of blood donors was initiated as a surrogate marker for non‐A, non‐B hepatitis. Increased sensitivity of subsequent HBV and HCV tests used for standard donor screening make any residual value of ALT testing questionable.

Cimetidine and agranulocytosis.

Excerpt To the editor: We read with interest the letter by de Galocsy and van Ypersele de Strihou (1) and the editorial by Freston (2) in the February 1979 issue. Cimetidine has been reported in as...

Human t–cell lymphotropic virus infection among blood donors in south florida

SummaryKnowledge of the epidemiologic pattern of human T-lymphotropic virus (HTLV) in the United States is being enlarged by blood donor screening. We tested stored sera from 29,937 donations made in South Florida in 1984–1985. Twenty-three donors were confirmed as seropositive, a prevalence of 0.8 per 1,000 donations. Specificity was supported by serologic retesting and virus culture of 11 donors located for follow-up. Sex- and age-specific prevalences did not differ significantly; blacks, however, accounted for 65% of seropositive donations. Within South Florida, one section of Miami had a prevalence of 4.5 per 1,000 donations, significantly above the 0.1 to 1.1 per 1,000 rates for other parts. An epidemiologic association with known HTLV-1 endemic areas could account for most infections; all seven typed isolates were characterized as HTLV-1. Exposures, however, were diverse, sometimes multiple, and had no necessary relationship to personal lifestyle. This finding suggests that sources of infection were varied. Seropositive family members emphasize familial clustering of HTLV-1 infection.

Prevalence of Anti-HIV and Anti-delta Among Deferred HBsAg-Positive Volunteer Blood Donors

Excerpt To the editor: Concomitant infection with the human immunodefiency virus (HIV) or delta infection among asymptomatic blood donors positive for hepatitis B surface antigen (HBsAg) has not be...