HTLV-I Antibody Status in Hemophilia Patients Treated with Factor Concentrates Prepared from U.S. Plasma Sources and in Hemophilia Patients with AIDS

Abstract

SummarySerum samples from 85 Austrian hemophilia patients treated with lyophilized factor concentrates prepared from U.S. plasma sources, 24 hemophilia patients from Georgia on a home therapy program with factor concentrates, and 10 U.S. hemophilia patients with acquired immunodeficiency syndrome (AIDS) were analyzed by two different methods for the presence of antibodies to the major internal antigen of human T-cell leukemia virus I (HTLV-I) p24. All but one, a Georgia sample, were negative. The absence of antibody to HTLV-I p24 in the serum of European hemophilia patients, of U.S. hemophilia patients with no symptoms of AIDS, and of U.S. hemophilia patients with AIDS is interpreted as an indication of the lack of ready transmissibility of HTLV-I in lyophilized factor concentrates.

Survival in a cohort of patients with haemophilia at the haemophilia care center in Vienna, Austria, from 1983 to 2006

“…In the extensive study from the UK, patients with severe haemophilia still had a decreased survival even if neither HIV-nor HCV-positive [20]. The results of a study conducted in the Netherlands for the period 1992 to 2001 [22] were quite similar to those of our study. In this study, patients with and without infection and with different severities of disease were included.…”

“…What is most probably unique in our study is that in most patients the diagnosis of HIV infection was already made in 1982/1983 from stored plasma samples. At that time we tested for HTLV‐I [22] and HIV in our patients. In addition, the number of included patients is quite representative when considering the overall prevalence of haemophilia A and B in Austria, which is ∼600 patients.…”

Human T‐lymphotropic virus and transfusion safety: does one size fit all?

“…There is no evidence that fresh‐frozen plasma and plasma‐derived medicinal products transmit HTLV‐1 and ‐2, presumably because of the death of HTLV‐infected lymphocytes due to plasma freezing and fractionation and for the fact that HTLVs are highly susceptible to inactivation by the many methods currently used in plasma fractionation . Isolated reports of HTLV‐1–positive persons with hemophilia can be found, but in most cases negative results are obtained when HTLV‐1 antibodies are assayed in this group of patients …”

The Current Risk of Retroviral Infections Transmitted by Transfusion in Patients Who Have Undergone Multiple Transfusions

“…Although our patients underwent transfusion with blood unscreened for HTLV antibodies during their lifetime, the risk of HTLV infection appears to be lower than that observed in the United States both before and after the introduction of the screening for blood donors. 12,22,23 Two possible explanations for this finding are the low frequency of HTLV infection among blood donors in Italy 24 and the routine administration of leukocytereduced red blood cells to patients homozygous for ␤ thalassemia, which seems to transmit HTLV less efficiently than standard cellular blood components. 25,26 In conclusion, our study provides experimental evidence that the application of reliable screening procedures for donor selection reduced the transmission of HIV infection through blood transfusion in 1989-1995 to less than 2 cases in 10 000 person-years or 1 case per 190 000 U of red blood cells transfused.…”