Eluding transfusion-transmitted HIV infection: report of two cases.

Two hemophilia A boys (FVIII: C < 1% and 2.2%), whose ages were 12 and 14 years. old, received fresh frozen plasma of 140 ml and 210 ml, respectively, in 1989. It was the 27th and 13th donation for each regular donor who was negative for anti-HIV testing. However, both donors had HIV seroconversion within 95 to 110 days after the last donation. They might have contracted HIV infection shortly after the last donation. Luckily, the two hemophiliac recipients are still in good health and negative for anti-HIV and HIV-antigen testings for 7 years.

HTLV-I antibody screening in donated blood and thalassemic patients.

The HTLV-I antibody screening by passive partial agglutination test, Serodia HTLV-I (Fuji-rebio Inc) was performed in a total of 1,225 male and 468 female blood donors from September 1992 to March 1993. In addition, a total of 64 multitransfused thalassemic patients were also studied. All of the sera from donors and patients in both study groups showed no reactive results for HTLV-I antibody. This finding indicated that the HTLV-I infection is not yet a problem in blood transfusion in Thailand. However, the scattered reports of HTLV-I infections from our region should urge the national authority on the surveillance of this infection by epidemiological survey and occasional screening in blood donors.

Evaluation of donor self exclusion program.

Donor self exclusion is a low technology procedure to avoid blood donations from the high-risk groups for HIV infection. This strategy has been widely used in western countries to reduce the risk of transfusion associated AIDS. At Ramathibodi Hospital, we conducted a study on donor self exclusion program during March-December 1991. It was found 2.60%-6.55% (mean = 4.59%) of a total of 4,286 units of blood that were from the donors who indicated that their blood may not be safe for transfusion while the rest of them declared that their blood was safe based on sexual behavior during the past 3 months and the history of intravenous drug use. Among 202 units of unsafe blood, there were 1 (0.49%) positive for HIV-Ag, 7 (3.46%) for anti-HIV, 5 (2.48%) for anti-HCV, 10 (4.95%) for HBsAg and 6 (2.97%) for VDRL while there was no HIV-Ag detected in 4,084 units of safe blood but 19 (0.46%) were positive for anti-HIV (p < 0.05), 65 (1.59%) for anti-HCV, 219 (5.36%) for HBsAg and 56 (1.37%) for VDRL. It was clearly demonstrated in this study that confidential self-exclusion or HIV-Ag testing would have eliminated this HIV-Ag reactive unit in the "window period" from transfusion, while the syphilis screening would not have had any value as a surrogate marker. However, self-exclusion programs are likely to prove too non-specific and need more time to educate the donors.(ABSTRACT TRUNCATED AT 250 WORDS)