title: Human T-lymphotropic virus laboratory testing of maternal blood at time of cord blood donations and clinical implications.
abstract: BACKGROUND
  In the United States, blood products are tested for infectious diseases including human T-lymphotropic virus (HTLV)-I/II. Positive results of maternal blood samples at the time of cord blood (CB) donation must be reported to mother and physician. Tests for HTLV have a high false-positive rate. This is problematic because there is no prenatal testing of the mother.
  
  
  METHODS
  This study involves 119,769 maternal blood samples at time of CB donation and evaluates positive results for HTLV in screening tests, supplemental immunoassays, and nucleic acid tests (NATs). Infectious disease markers (IDMs) and maternal health histories of HTLV-positive and -negative mothers were compared.
  
  
  RESULTS
  Of 119,769 mothers donating CB, 545 tested positive with the screening test, 33 were positive with the supplemental tests, and two were positive with NAT. When indeterminate results were excluded from the supplemental test only six were positive. Eight of 34 mothers with positive or indeterminate supplemental test results had received intravenous immunoglobulin. There were no significant differences between HTLV-positive and -negative mothers with regard to the incidence of other IDMs.
  
  
  CONCLUSIONS
  Testing maternal blood for HTLV is problematic for CB banks, obstetricians, and mothers because of the high false-positive rate. CB banks need rapid turnaround time and supplemental testing. If results on the latter are positive the obstetrician should be notified, educated, do follow-up testing, and counseling. Indeterminate results on supplemental tests are most likely false positives. We recommend that mothers with positive or indeterminate supplemental test results have follow-up NAT.
authors.affiliation: CBR Systems, Inc., Tucson, Arizona 85756, USA. lglasser@cordblood.com
authors.forename: Lewis
authors.initials: L
authors.lastname: Glasser
authors.forename: Sherri
authors.initials: S
authors.lastname: Cyrus
authors.forename: Jason T
authors.initials: JT
authors.lastname: Machan
authors.forename: Jill
authors.initials: J
authors.lastname: Mapother
mesh_terms: D001771:Blood Banks / Q000706:statistics & numerical data; D058731:Blood Safety / Q000706:statistics & numerical data*; D015480:Deltaretrovirus Antibodies / Q000097:blood; D005189:False Positive Reactions; D005260:Female; D005312:Fetal Blood / Q000821:virology*; D015490:HTLV-I Infections / Q000097:blood / Q000453:epidemiology / Q000635:transmission; D015491:HTLV-II Infections / Q000097:blood / Q000453:epidemiology / Q000635:transmission; D015368:Human T-lymphotropic virus 1 / Q000302:isolation & purification*; D015367:Human T-lymphotropic virus 2 / Q000302:isolation & purification*; D006801:Humans; D008487:Medical History Taking; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data; D015995:Prevalence; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D014481:United States / Q000453:epidemiology
chemical_list: D015480:Deltaretrovirus Antibodies