Frequency of HIV type 2 infections among blood donor population from India: A 10-year experience.

Purpose: In India, HIV-2 epidemic is alongside with HIV-1. Blood banks are introducing nucleic acid testing (NAT) for screening. The limitation of NAT systems is the inability to detect HIV-2. Materials and Method : An analysis of HIV screening of a blood bank at a tertiary care center from 1998 to 2007 was carried out. Results : A total of 175026 donors were screened by serological assays and 789 were reactive for HIV antibody. Only 478 (61%) were confirmed positive by Western blot/immunoblot. There were 465 (97.2%) donations positive for HIV-1, 6 (1.3%) for HIV-2 (monotypic infection) and 7 (1.5%) for HIV-1 and HIV-2 (dual infection). Conclusion : We show the presence of HIV-2 infection among the blood donors and the need for incorporating HIV-2 detection also in the NAT systems.

Haemostasis with cryoprecipitate in patients undergoing surgery for severe von Willebrand disease.

BACKGROUND: There are limited data on the management of haemostasis in patients with severe von Willebrand disease undergoing major surgery. Data on the use of cryoprecipitate in this setting are even more limited. In many developing countries cryoprecipitate is often the only available source of factor replacement. The minimum factor levels required for maintaining haemostasis after surgery have never been carefully evaluated. METHODS: Data from 3 patients with severe von Willebrand disease who underwent 4 major surgical procedures at our institution, using lower than standard recommended doses of cryoprecipitate were analysed for adequacy of factor replacement and complications. RESULTS: The average preoperative cryoprecipitate infusion was 22.5 i.u. of factor VIII/kg (range: 15-25). The bleeding time done by the modified Ivy method, 30 minutes after infusion, was normal in all these patients. The average cryoprecipitate support for days 1-3 was 16.5 i.u. of factor VIII/kg/day (range: 12.5-25) and for days 4-10 was 12.4 i.u. of factor VIII/kg/day (range: 8.3-16). The mean duration of factor replacement was 12 days (range: 7-17). Two patients had delayed bleeding, one on day 3 attributed to the inadvertent use of a non-steroidal anti-inflammatory drug and the second on day 10 which was probably secondary to septicaemia. Bleeding resolved in both these patients as soon as the precipitating factors were relieved. CONCLUSION: The total amount of factor replaced in our patients is approximately half of what would have been used if the usual recommendations were followed. The data suggests that lower doses of cryoprecipitate could be adequate for major surgery and wound healing in severe von Willebrand disease. This will lead to lowering of costs and reducing the risk of transfusion-associated virus infection.

Antigenic similarity of a cultivable acid fast bacterium to Mycobacterium leprae.

A cultivable acid fast stainable bacterium obtained from leprosy nodule showed similarity to M. leprae in antigenicity to serum antibodies of lepromatous leprosy patients. The antigenic similarity has been seen more clearly in the delipidified cell components of both these bacteria. An antigen of 35-38 kDa has been seen as a common antigen between M. leprae and the cultivable bacilli with binding ability to sera from leprosy patients. This cultivable bacterial component could be used for serodiagnosis of lepromatous leprosy.