Blood product acquired HIV infection in children.
The medical community needs to ensure safety of blood and blood products. Blood bankers have instituted rigid criteria for exclusion of potential donors in high risk categories. Institution of HIV testing would appear to make blood products safer although the complete elimination of HIV contaminated blood and blood products may not be possible. The ELISA test is excellent for screening but misses approximately 1 in 200 (0.5%) HIV infected donors. Donor-screened, heat-treated factor VIII products appear to be quite effective in protecting the hemophilia population. However, we must continue to search for methodologies and techniques which will further guarantee blood product safety. The following methodologies have been suggested and warrant strong consideration: Vigilance in exclusion of potential high risk donors. Newer methodologies for retrovirus screening including the use of other surrogate markers. Institution of screening for HTLV-I and other retroviruses with attention to population surveillance for newer agents. Institution of cleaner methods of extracting specific blood components by monoclonal antibody techniques and DNA methodologies. For hemophiliacs, development of recombinant DNA products which by-pass the need for plasma derived clotting factors. It is predicted that such products should become available for use in about two years. In the interim, all clotting factors used should be donor-screened and virus-inactivated (by heat treatment, detergent washing and/or other newer methodologies). For the blood recipient, programs allowing for self donation prior to elective surgery and designated donors should be implemented. Although such programs may be logistically difficult, they should be given high priority.(ABSTRACT TRUNCATED AT 250 WORDS)
Desposito
F
F
Department of Pediatrics, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark 07103.
McSherry
G D
GD
Oleske
J M
JM
D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis / Q000635:transmission*; D001782:Blood Donors; D002648:Child; D006679:HIV Seropositivity; D006402:Hematologic Diseases / Q000628:therapy; D006467:Hemophilia A / Q000628:therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009369:Neoplasms / Q000628:therapy; D065227:Transfusion Reaction