Psychological distress in blood donors notified of HTLV-I/II infection. Retrovirus Epidemiology Donor Study.

BACKGROUND: Blood donations in the United States have been screened for antibody to human T-cell lymphotropic virus types I and II (HTLV-I/II) since November 1988. Although clinically diagnosed illness associated with HTLV-I/II remains relatively uncommon, blood donors notified of HTLV infection frequently report negative psychological and social effects following notification. STUDY DESIGN AND METHODS: To assess psychological outcomes, the General Well-Being Scale, a standardized 18-item questionnaire, was administered to 464 HTLV-I/II-positive donors and 91 sex partners at five blood centers in the United States following notification of HTLV-I/II infection. The questionnaire was also given to 735 HTLV-I/II-negative donors. RESULTS: Scores for donors seropositive for HTLV-I and HTLV-II showed significantly more psychological distress than did scores for seronegative donors (p < 0.0005) or a large national sample (p < 0.05). Both HTLV-I (p = 0.02) and HTLV-II (p = 0.01) seropositivity remained significant predictors of lower overall well-being scores after analysis controlling for race, age, gender, education, income, donation type, time since notification, self-reported health status, and intravenous drug use. Variables that predicted higher overall scores were negative HTLV status, older age, higher income, better health, fewer sick days, and fewer work limitations due to health problems. CONCLUSION: Increased psychological distress may be related to notification of HTLV infection among blood donors in the United States.

Determination of human T lymphotropic virus type by polymerase chain reaction and correlation with risk factors in northern California blood donors.

To determine the relative prevalence of human T lymphotropic virus (HTLV) types I and II, type-specific polymerase chain reaction (PCR) was done on seropositive northern California blood donors. From October 1988 through March 1990, 67 (0.055%) of 122,517 blood donors had confirmed HTLV antibody. Seropositive donors were more likely to be middle-aged, female, and nonwhite than the overall donor base. PCR of samples from 30 HTLV-seropositive donors yielded 19 (63%) with HTLV-II and 9 (30%) with HTLV-I; 2 (7%) were repeatedly negative by PCR. HTLV-I-infected subjects had ancestry (n = 3), sexual contact (n = 3), or paternal military service in (n = 1) Japan or the Caribbean. HTLV-II carriers reported past intravenous drug abuse (n = 3) or sex with a drug user (n = 11). Two carriers of each type reported previous blood transfusions, and 1 HTLV-II carrier was a dentist with no other risk factors for retroviral infection.

Safety of blood donations following a natural disaster.

To evaluate the relative safety of blood donations given in response to a major disaster, donor demographics and infectious disease test results were compared for donations made during the 10 days following the October 17, 1989, San Francisco Bay Area earthquake and those made during the preceding 6 months. These comparisons were made for donations given to the regional blood center in the area that was immediately affected by the disaster (Irwin Memorial Blood Centers) and for those given in an unaffected region (Los Angeles/Orange Counties Region, American Red Cross Blood Services). The rate of donation increased more than 200 percent during the 5 days following the earthquake in both the disaster-affected and unaffected regions. Both the disaster-affected and unaffected regions observed significant increases in the proportions of donations by first-time donors, by persons aged 20 to 39 years, and by women. The rates of confirmed positivity for infectious disease markers for post-earthquake donations did not differ significantly from rates for homologous donations given during the preceding 6 months, particularly when the rates were adjusted for the increased representation of first-time donors. Approximately 39 percent of post-earthquake first-time donors gave blood again within the following 6-month period. It is concluded that donations given after major disasters are essentially as safe as routine donations and that active efforts to recruit these donors again can be undertaken without reservation.