Lack of difference in cytomegalovirus transmission via the transfusion of filtered-irradiated and nonfiltered-irradiated blood to newborn infants in an endemic area

BACKGROUND: It is accepted that white cells contained in blood components a re the most significant source of cytomegalovirus (CMV) infection in immuno compromised and immunodeficient recipients. STUDY DESIGN AND METHODS: To determine whether white cell filtration of blo od would be effective in preventing infection among newborn transfusion rec ipients in a hyperendemic area, a randomized study was performed. All donor blood units were irradiated before issue to prevent posttransfusion graft- versus-host disease. Recipients were monitored for CMV infection by serocon version (development of IgM anti-CMV) and CMV-DNA isolation. RESULTS: Th ree (9%) of 33 infants who received filtered blood and 1 (5%) o f 19 infants given nonfiltered blood were infected with CMV, as determined by the presence of IgM anti-CMV and/or CMV DNA isolation. There was no sign ificant difference in the rate of CMV infection in the two groups. CONCLUSION: The CMV infection observed in the study may come from other rou tes such as breastfeeding, rather than from transfusion. Our findings sugge st that the routine use of white cell-reduction filtration to reduce the ri sk of transmitting CMV is unwarranted for neonates in endemic regions.