Margaret Hanson

Absence of HIV Infection in Blood Donors with Indeterminate Western Blot Tests for Antibody to HIV-1

To determine whether apparently healthy persons who have had repeatedly reactive enzyme immunoassays and an indeterminate Western blot assay for antibody to the human immunodeficiency virus type 1 (HIV-1) are infected with HIV-1 or HIV-2, we studied 99 such volunteer blood donors in a low-risk area of the country. The subjects were interviewed about HIV risk factors. Coded blood specimens were tested again for HIV-1 antibody (by two different enzyme immunoassays, a Western blot assay and a radioimmunoprecipitation assay) and for HIV-2 antibody by enzyme immunoassay, for HIV-1 by the serum antigen test, for HIV-1 by culture, for human T-cell leukemia virus Type I or II antibody by enzyme immunoassay, and for sequences of HIV DNA by the polymerase chain reaction. Of the 99 blood donors, 98 reported no risk factors for HIV-1 infection; 1 donor had used intravenous drugs. After a median of 14 months (range, 1 to 30) from the time of the initial test, 65 subjects (66 percent) were still repeatedly reactive for HIV-1 antibody on at least one immunoassay. In 91 subjects (92 percent) the Western blot results were still indeterminate, whereas in 8 they were negative. No donor met the criteria for a positive Western blot assay for HIV-1, and none had evidence of HIV-1 or HIV-2 infection on culture or by any other test. We conclude that persons at low risk for HIV infection who have persistent indeterminate HIV-1 Western blots are rarely if ever infected with HIV-1 or HIV-2.

Evaluation of clinical and laboratory aspects of antibody tests for detection of hepatitis C virus infection in blood donors and recipients from a low-risk population.

Background: When the first‐generation enzyme immunoassay (EIA) for detection of antibody to hepatitis C virus (anti‐HCV) was approved in May 1990, blood banking agencies recommended testing of all components in inventory. In many cases, one or more components from these units had already been transfused.

Potential risk of salivary-mediated viral hepatitis type B transmission from oral exposure to fomites

Twelve grade school and junior high school students had oral exposures to hepatitis B surface antigen (HBsAg) positive saliva via contact with contaminated musical instruments. The 12 exposed students and 18 students who served as age and sex matched controls were tested for the presence of HBsAg and antibody to the hepatitis surface antigen (anti-HBs) at 2 weeks, 8 weeks and 6 months after exposure. All students were negative for HBsAg and anti-HBs on all dates tested and reported no illness during that time suggestive of viral hepatitis. There was no evidence of viral hepatitis, type B transmission from the exposure. The students probably experienced the maximum possible oral exposure from direct or fomites contact, since there was no cleaning of the musical instruments between use by the students and teacher. Based on these results, the risk of transmission of viral hepatitis, type B from oral contact with fomites is unlikely.

Subtypes of Hepatitis B Surface Antigen in Native-Born and Immigrant Israelis

Abstract. A survey of HBsAg among Jerusalem blood donors revealed a prevalence of 0.89% and a predominance of subtype uy (85%) compared with ad (15%). A simultaneous survey of patients with HBsAg‐positive viral hepatitis revealed a similar predominance of ay (85%) compared with ad (1 5%). The uniform distribution of the dominant ay subtype among both carriers and patients, representing a diversity of ethnic and national origins, supports the premise that ad and ay subtypes are preferentially correlated with regional epidemiologic, rather than host or disease‐related factors.