title: Window-period human immunodeficiency virus transmission to two recipients by an adolescent blood donor.
abstract: BACKGROUND
  Pooled NAT and donor screening have reduced the diagnostic window period for HIV in the blood donor population to approximately 10 to 15 days. This report describes two cases of transfusion-acquired HIV infection and verification of transmission from the donor to the recipients, and attempts to identify how the 18-year-old donor acquired her infection.
  
  
  METHODS
  After a repeat donor had a positive HIV test result, two recipients of the donor's previous donation were identified and tested. The donor and recipients were interviewed and blood samples were obtained for HIV DNA sequencing and phylogenetic analysis.
  
  
  RESULTS
  The two recipients had positive HIV test results. Phylogenetic analysis showed a high genetic similarity among the viruses (bootstrap 100%), consistent with transmission from the donor to the recipients. Four of five men with whom the donor had sexual contact during the critical time period when infection most likely occurred were located and tested; results were negative for HIV.
  
  
  CONCLUSIONS
  Pooled NAT of blood donations has not eliminated the window period for HIV identification during seroconversion.
authors.affiliation: Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. RPhelps@cdc.gov
authors.forename: Ruby
authors.initials: R
authors.lastname: Phelps
authors.forename: Kenneth
authors.initials: K
authors.lastname: Robbins
authors.forename: Thomas
authors.initials: T
authors.lastname: Liberti
authors.forename: Ana
authors.initials: A
authors.lastname: Machuca
authors.forename: German
authors.initials: G
authors.lastname: Leparc
authors.forename: Mary
authors.initials: M
authors.lastname: Chamberland
authors.forename: Marcia
authors.initials: M
authors.lastname: Kalish
authors.forename: Indira
authors.initials: I
authors.lastname: Hewlett
authors.forename: Thomas
authors.initials: T
authors.lastname: Folks
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Lee
authors.forename: Matthew
authors.initials: M
authors.lastname: McKenna
mesh_terms: D015492:AIDS Serodiagnosis; D000293:Adolescent; D016358:Contact Tracing; D018562:Disease Transmission, Infectious; D005188:False Negative Reactions; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000635:transmission*; D006679:HIV Seropositivity / Q000097:blood / Q000175:diagnosis; D015497:HIV-1 / Q000235:genetics; D006801:Humans; D008403:Mass Screening; D010802:Phylogeny; D012367:RNA, Viral / Q000235:genetics; D012689:Sequence Homology, Nucleic Acid; D012747:Sexual Partners; D065227:Transfusion Reaction
chemical_list: D012367:RNA, Viral