title: Failure and success of HIV tests for the prevention of HIV-1 transmission by blood and tissue donations.
abstract: French blood banks recently implemented nucleic acid testing (NAT) of all blood donations to reduce the risk of HIV transmission during the pre-seroconversion period. For tissue donation, HIV infection screening relies on HIV p24 antigen and anti-HIV-1 and 2 antibody detection. In this report, two related cases of infectious donations are described from a cornea donor during the preseroconversion window who was infected by an HIV antibody and NAT negative blood donor. After investigation, the blood donor was found to be herself in the preseroconversion window. Two months after donation, she was found to be HIV positive. The residual risk of HIV infectious blood donations since NAT has been introduced is estimated to be lower than one out of 2.5 millions. Individual NAT instead of minipool testing would not increase significantly the blood transfusion safety. In contrast, introduction of NAT should be considered to increase tissue donation safety as soon as such screening will be possible technically.
authors.affiliation: Laboratory of Virology and Transplantation Unit, Hôpital Edouard Herriot, Lyon, France. naijou@rockefeller.edu.au
authors.forename: Fatiha
authors.initials: F
authors.lastname: Najioullah
authors.forename: Valérie
authors.initials: V
authors.lastname: Barlet
authors.forename: Philippe
authors.initials: P
authors.lastname: Renaudier
authors.forename: Cathy
authors.initials: C
authors.lastname: Guitton
authors.forename: Philippe
authors.initials: P
authors.lastname: Crova
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Guérin
authors.forename: Dominique
authors.initials: D
authors.lastname: Peyramond
authors.forename: Marie-Anne
authors.initials: MA
authors.lastname: Trabaud
authors.forename: Nicole
authors.initials: N
authors.lastname: Coudurier
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Tardy
authors.forename: Patrice
authors.initials: P
authors.lastname: André
mesh_terms: D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D001483:Base Sequence; D001769:Blood / Q000821:virology*; D001782:Blood Donors; D005260:Female; D005814:Genes, Viral; D016655:HIV Core Protein p24 / Q000032:analysis; D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control / Q000635:transmission*; D016333:HIV Protease / Q000235:genetics; D054303:HIV Reverse Transcriptase / Q000235:genetics; D015497:HIV-1 / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D008969:Molecular Sequence Data; D012367:RNA, Viral / Q000097:blood; D016415:Sequence Alignment; D012689:Sequence Homology, Nucleic Acid; D014019:Tissue Donors; D019737:Transplants / Q000821:virology*
chemical_list: D000914:Antibodies, Viral; D016655:HIV Core Protein p24; D012367:RNA, Viral; D054303:HIV Reverse Transcriptase; D016333:HIV Protease