TRANSFUSION-ASSOCIATED HIV-INFECTION

Objective: Estimating the risk of HIV transmission by blood or inactiv ated plasma transfusion. A discussion of the methods and techniques fo r the diagnosis of HIV infection in blood donors. Data sources: Report s in German and English on this topic as well as own experiences of th e authors. Selection Criteria: No specific selection criteria. Results : Transfusion associated HIV infection may be prevented by donor selec tion, the very efficient anti-HIV testing: by p24-antigen testing that may detect some anti-HIV negative donations especially during the ear ly time of seroconversion and by more recent introduced techniques lik e polymerase chain reaction (PCR) and signal amplification assay (SAA) . PCR and SAA are under development and until now not sensitive and sp ecific enough to contribute significantly to an earlier detection of H IV infected blood. Procedures for the inactivation of HIV in plasma or whole blood have been described. Until now use of psoralenes, methyle ne blue or direct UV irradiation may reduce viral load but have not de finitely been proven by clinical trials to be 100% efficient. Conclusi ons: To minimize transfusion associated HIV infection in future years reduction of total amount of transfused units, restriction to regional donor recruting and further refinement of tests will be necessary. A 100% safety of blood transfusion for infectious agent cannot be achiev ed, especially considering new agents and further spread of until now geographically restricted viruses.