This is a novel case report of alloimmune neonatal neutropenia (ANN) linked to the neutrophil antibody anti-HNA-4a (MART). Since its discovery, the HNA-4a antigen has never been associated with any clinical neutropenia. A first-born neonate with respiratory distress was found to be severely neutropenic, because of ANN. The broad reactivity of the antibody together with its capture by CD11b and CD18 in monoclonal antibody immobilization of granulocyte antigen test suggested HNA-4a specificity. DNA sequencing confirmed that the father is HNA-4a-positive and that the mother is HNA-4a-negative, supporting the diagnosis of ANN linked to MART.
Exposure to GBV-C can commence at an early age, although ongoing exposure may also occur among adults with no apparent risk factors. GBV-C RNA positivity was not associated with abnormal plasma alanine aminotransferase levels among blood donors.
Objective
To determine the prevalence of hepatitis G virus (HGV) carriage in Queensland blood donors.
Design
Cross‐sectional survey with retrospective longitudinal study of HGV‐positive donors.
Setting
Brisbane Red Cross Blood Bank, 1995.
Subjects
100 consecutive blood donors attending the Blood Bank on two days in October 1995 and 20 blood donors with a raised plasma alanine aminotransferase (ALT) level on their last donation.
Outcome measures
Presence of HGV RNA by reverse transcription polymerase chain reaction (RT‐PCR) in currently donated blood and in blood samples archived for up to 34 months. RT‐PCR used two different reverse transcription methods and three different specific sets of primers and probes.
Results
Five of the 120 blood donors were positive for HGV RNA by all RT‐PCR methods (four of the 100 with normal ALT levels [4%] and one of the 20 with raised ALT levels [5%]). Retrospective testing of archived samples showed that four of these five had been persistently HGV RNA‐positive for at least two years, while the fifth had been HGV RNA‐negative on two donations before becoming HGV RNA‐positive. No risk factors were identified for this donor.
Conclusions
A relatively large number of Queensland blood donors (4%) are persistently HGV RNA‐positive.
The comparison of the performance of PDT with SDT sites identified only minor differences that did not adversely impact on the timely release of blood products. Although both ID and MP strategies showed excellent specificity, irrespective of site configuration, the significantly increased NRR rate, observed exclusively for ID testing performed at SDT sites, indicates a potential for contamination that may limit the number of samples that can optimally be processed using ID testing. The performance data for ID testing in particular should serve as a useful benchmark for evaluating candidate NAT systems that are fully automated.
Phylogenetic analysis suggests that these latter sequences are either a new HGV/GBV-C Pacific type or a subtype of the Asian type RNA virus. Isolates homologous with type 1 were not identified in these population groups.
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