SCREENING OF BLOOD-DONORS FOR IDIOPATHIC CD4+ T-LYMPHOCYTOPENIA

被引:36
作者
BUSCH, MP
VALINSKY, JE
PAGLIERONI, T
PRINCE, HE
CRUTCHER, GJ
GJERSET, GF
OPERSKALSKI, EA
CHARLEBOIS, E
BIANCO, C
HOLLAND, PV
PETERSEN, LR
HOLLINGSWORTH, CG
MOSLEY, JW
机构
[1] NEW YORK BLOOD CTR,SPECIAL DIAGNOST LAB,NEW YORK,NY 10021
[2] SACRAMENTO MED FDN CTR BLOOD RES,SACRAMENTO,CA
[3] AMER RED CROSS,TISSUE SERV,LOS ANGELES,CA
[4] CTR DIS CONTROL,NATL CTR INFECT DIS,DIV HIV AIDS,HIV SEROEPIDEMIOL BRANCH,ATLANTA,GA 30333
[5] UNIV CALIF SAN FRANCISCO,DEPT LAB MED,SAN FRANCISCO,CA 94143
[6] AMER RED CROSS,BLOOD SERV,LOS ANGELES,CA
[7] UNIV SO CALIF,SCH MED,LOS ANGELES,CA 90033
[8] PUGET SOUND BLOOD CTR,SEATTLE,WA 98104
[9] NHLBI,BETHESDA,MD 20892
[10] UNIV CALIF SAN FRANCISCO,SAN FRANCISCO GEN HOSP,SCH MED,DEPT EPIDEMIOL & BIOSTAT,SAN FRANCISCO,CA 94110
关键词
D O I
10.1046/j.1537-2995.1994.34394196614.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The recent recognition of idiopathic CD4+ T-lymphocytopenia (ICL) has led to concern that an unknown immunodeficiency virus may be transmissible by transfusion. Study Design and Methods: To evaluate the prevalence and significance of low CD4+ values among blood donors, CD4, data on 2030 blood donors who were negative for antibody to human immunodeficiency virus type 1 (HIV-1) were compiled. Those with CD4+ values below ICL cutoffs (<300 CD4+ T cells/muL, or <20% CD4+ T cells) were recalled for follow-up investigations. Serial CD4+ data on 55 homosexual men who seroconverted during prospective follow-up and data on 139 anti-HIV-1-positive blood donors initially evaluated in 1986 were reviewed as well. Results: Five seronegative donors (0.25%) had absolute CD4+ counts <300 cells per muL and/or <20 percent. On follow-up, all five donors had immunologic findings within normal ranges, lacked HIV risk factors, and tested negative for HIV types 1 and 2 and human T-lymphotropic virus type I and II infections by antibody and polymerase chain reaction assays. Four of five donors reported transient illnesses shortly after their low CD4+ count donations. The median interval from HIV-1 seroconversion to an initial CD4+ value below ICL CD4+ cutoffs was 63 months for infected homosexual men. Of 139 HIV-1-infected blood donors studied 1 to 2 years after seropositive donations, 34 (24%) had CD4+ counts <300 cells per muL and/or <20 percent. Conclusion: Low CD4+ counts are rare among anti-HIV-1 -negative volunteer blood donors and are generally associated with transient illnesses. If any unknown virus progresses similarly to HIV-1, CD4+ count donor screening would be a poor surrogate for its detection.
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收藏
页码:192 / 197
页数:6
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