Inactivation of infectious pathogens in labile blood components: meeting the challenge

Substantial improvement in the safety of blood transfusion has been achieve d through the addition of new tests, such as nucleic acid tests, yet residu al risk associated with transfusion of blood components persists. Transfusi on of blood components has been implicated in the transmission of viruses, bacteria, and protozoa. While it is commonly recognized that hepatitis B vi rus (HBV), hepatitis C virus (HCV), cytomegalovirus (CMV), and the retrovir uses, such as human immunodeficiency virus (HIV) and the human lymphotrophi c viruses (HTLV) can be transmitted through cellular components, other path ogens are emerging as potentially significant transfusion-associated infect ious agents. For example, transmission of protozoan infections due to trypa nosomes and babesia have been reported. In addition to viral and protozoal infectious agents, bacterial contamination of platelet and red cell concent rates continues to be reported: and may be an under-reported transfusion co mplication. More importantly, new infectious agents may periodically enter the donor population before they can be definitively identified and tested for to maintain consistent safety of the blood supply. The paradigm for thi s possibility is the HIV pandemic, which erupted in 1979. During the past d ecade a number of methods to inactivate infectious pathogens in labile bloo d components have been developed and have entered the advanced clinical tri al phase. (C) 2001 Editions scientifiques et medicales Elsevier SAS.