Long-term follow-up of blood donors with indeterminate human immunodeficiency virus type 1 results on Western blot.
BACKGROUND
At present, tens of thousands of United States blood donors who are at low risk for human immunodeficiency virus type 1 (HIV-1) infection are indefinitely deferred. These persons are repeatably reactive for HIV-1 antibody in enzyme immunoassay (EIA) and are indeterminate in Western blot.


METHODS
To determine the significance and persistence of anti-HIV-1 reactivity in plasma from volunteer blood donors with HIV-1-indeterminate Western blots, 66 donors were retested for HIV-1 antibody by the same manufacturers' EIA and Western blot 5 to 7 years after the initial Western blot. In addition, donors' peripheral blood mononuclear cells were tested by polymerase chain reaction (PCR) for HIV-1 DNA gag sequences.


RESULTS
Thirty-five (53%) of 66 donors were still repeatedly reactive for HIV-1 on EIA and indeterminate on Western blot, 23 (35%) were negative on EIA and indeterminate on Western blot, 7 (11%) were negative in EIA and Western blot, and 1 (2%) was repeatedly reactive on EIA and negative on Western blot. Donors with persistently indeterminate Western blots had a band pattern nearly identical to that on the original Western blot. No donor was positive in Western blot, p24 antigen, or PCR testing. No donor had signs or symptoms of HIV-1 infection.


CONCLUSIONS
Long-term follow-up of Western blot-indeterminate blood donors does not reveal evidence of HIV-infection. A mechanism to return these donors to the donor pool should be considered.
Jackson
J B
JB
Institute of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio.
Hanson
M R
MR
Johnson
G M
GM
Spahlinger
T G
TG
Polesky
H F
HF
Bowman
R J
RJ
D001483:Base Sequence; D001782:Blood Donors; D015153:Blotting, Western; D004247:DNA / Q000032:analysis; D005500:Follow-Up Studies; D015483:HIV Antibodies / Q000097:blood*; D016655:HIV Core Protein p24 / Q000097:blood; D015497:HIV-1 / Q000235:genetics / Q000276:immunology*; D006801:Humans; D007124:Immunoenzyme Techniques; D016133:Polymerase Chain Reaction; D013997:Time Factors
D015483:HIV Antibodies; D016655:HIV Core Protein p24; D004247:DNA