RESUMO
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 Assuntos
Doadores de Sangue
, Transmissão de Doença Infecciosa
, Transfusão de Eritrócitos/efeitos adversos
, Infecções por HIV/transmissão
, HIV-1/isolamento & purificação
, Técnicas de Amplificação de Ácido Nucleico
, RNA Viral/sangue
, Viremia/transmissão
, Adulto
, Reações Falso-Negativas
, Ligação Genética
, Anticorpos Anti-HIV/sangue
, Proteína do Núcleo p24 do HIV/sangue
, Infecções por HIV/sangue
, Soropositividade para HIV
, HIV-1/genética
, Humanos
, Masculino
, Programas de Rastreamento
, Filogenia
, Homologia de Sequência do Ácido Nucleico
, Carga Viral
, Viremia/virologia