Window‐period human immunodeficiency virus transmission to two recipients by an adolescent blood donor

Phelps, Ruby; Robbins, Kenneth E.; Liberti, Thomas M.; Machuca, Ana; Leparc, Germán F.; Chamberland, Mary E.; Kalish, Marcia L.; Hewlett, Indira; Folks, Thomas M.; Lee, Lisa M.; McKenna, Matthew T.

doi:10.1111/j.1537-2995.2004.03364.x

Cited by 71 publications

(56 citation statements)

References 17 publications

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“…Prior to the use of MP-NAT, HIV was transmitted via window-stage donations at significant rates (5,22). Although very rarely, HIV has been transmitted by window period blood donations that were determined to have Յ150 vRNA copies/ml even after the adoption of MP-NAT (9,11,35,36). The occurrence of rare HIV transmission events by donations with no evidence of anti-HIV antibodies and very low vRNA levels is consistent with our findings.…”

Section: Discussionsupporting

confidence: 80%

High Specific Infectivity of Plasma Virus from the Pre-Ramp-Up and Ramp-Up Stages of Acute Simian Immunodeficiency Virus Infection

Zhong

Stone

Piatak

et al. 2009

J Virol

116

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To define the ratio of simian immunodeficiency virus (SIV) RNA molecules to infectious virions in plasma, a ramp-up-stage plasma pool was made from the earliest viral RNA (vRNA)-positive plasma samples (collected approximately 7 days after inoculation) from seven macaques, and a set-point-stage plasma pool was made from plasma samples collected 10 to 16 weeks after peak viremia from seven macaques; vRNA levels in these plasma pools were determined, and serial 10-fold dilutions containing 1 to 1,500 vRNA copies/ml were made. Intravenous (i.v.) inoculation of a 1-ml aliquot of diluted ramp-up-stage plasma containing 20 vRNA copies infected 2 of 2 rhesus macaques, while for the set-point-stage plasma, i.v. inoculation with 1,500 vRNA copies was needed to transmit infection. Further, when the heat-inactivated set-point-stage plasma pool was mixed with ramp-up-stage virions, infection of inoculated macaques was blocked. Notably, 2 of 2 animals inoculated with 85 ml of a pre-ramp-up plasma pool containing <3 SIV RNA copies/ml developed SIV infections characterized by high levels of viral replication, demonstrating that "vRNA-negative" plasma collected from macaques in the pre-ramp-up stage is infectious. Furthermore, there is a high ratio of infectious virions to total virions in ramp-up-stage plasma (between 1:1 and 1:10) and a lower ratio in set-point-stage plasma (between 1:75 and 1:750). Heat-inactivated chronic-stage plasma can "neutralize" the highly infectious ramp-up-stage virions. These findings have implications for the understanding of the natural history of SIV and human immunodeficiency virus infection and transmission.

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Section: Discussionsupporting

confidence: 80%

High Specific Infectivity of Plasma Virus from the Pre-Ramp-Up and Ramp-Up Stages of Acute Simian Immunodeficiency Virus Infection

Zhong

Stone

Piatak

et al. 2009

J Virol

116

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“…The authors state that the blood donation and transfusion of blood components occurred in Singapore, where blood donation testing for HIV is similar to US protocols, including anti-HIV-1 and anti-HIV-2 EIAs and an HIV-1 p24 antigen EIA (Ling et al 2000). In another report two infections were caused by a blood donation in 2002 (Phelps et al 2004). The donor was an adolescent repeat donor who tested HIV antibody positive in May 2002, and the previous donation (3 months earlier) must have been during the seronegative WP and at the eclipse of the virus too.…”

Section: Infectious Blood and Blood Products From Donors At The Seronmentioning

confidence: 99%

The HIV Seronegative Window Period: Diagnostic Challenges and Solutions

Jehuda-Cohen¹

2011

Recent Translational Research in HIV/AIDS

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“…Most blood donations are done commercially for economic gains, so that transfusion with an improperly screened blood remains a possibility. Despite these better blood screening procedures, HIV transmission may still occur if the blood donation occurred during the window period (when the blood of a newly infected person does not show up as positive on screening tests) [6][7][8], if the potential blood donor is infected with variant strains of HIV that may escape detection by current screening assays or following testing or documentation errors [7]. Almost all recipients of HIV-positive unit of blood/blood product will develop HIV-infection [8,9], and will manifest with symptoms of AIDS within a shorter incubation time especially in young children [10].…”

Section: Discussionmentioning

confidence: 99%

Horizontal transmission of HIV infection in an HIV-exposed child—An avoidable tragedy

Ugwu¹

2013

CRCM

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Exposure to infected blood/blood products through blood transfusion and use of contaminated sharp objects remain an important source of HIV infection. This report describes the case of a 52-month-old male child of an HIV-infected mother in whom perinatal infection was successfully prevented by maternal and infant antiretroviral therapy, elective cesarean section, and avoidance of breast-feeding. A DNA PCR test at 6 weeks was negative and a rapid antibody test at 18 months was seronegative. He presented to the Paediatric infectious disease unit with chronic fever, cough, diarrhea and weight loss 7 months after receiving a commercially donated blood (in a rural private hospital) and scarification marks (by a traditional healer) for a febrile illness with convulsion. He was found to be seropositive with severe immunosuppression. He however died a month after being initiated on antiretroviral drug.

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Window‐period human immunodeficiency virus transmission to two recipients by an adolescent blood donor

Abstract: Pooled NAT of blood donations has not eliminated the window period for HIV identification during seroconversion.

Cited by 71 publications

References 17 publications

High Specific Infectivity of Plasma Virus from the Pre-Ramp-Up and Ramp-Up Stages of Acute Simian Immunodeficiency Virus Infection

High Specific Infectivity of Plasma Virus from the Pre-Ramp-Up and Ramp-Up Stages of Acute Simian Immunodeficiency Virus Infection

The HIV Seronegative Window Period: Diagnostic Challenges and Solutions

Horizontal transmission of HIV infection in an HIV-exposed child—An avoidable tragedy

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