HIV transmissions from a window-period platelet donation

Recently, blood centers began investigational testing for HIV RNA by pooled nucleic acid testing (NAT). A 35-year-old frequent platelet donor tested H IV p24 antigen positive, antibody negative before implementation of NAT He made 2 platelet donations (day -4 and -11) immediately before testing posit ive for HIV The donor's HIV seroconversion was monitored, and stored sample s were tested retrospectively for HIV RNA. Platelet recipients were tested for HIV infection. The day -4 sample tested positive for HIV RNA by pooled and individual sample NAT The day -11 sample tested negative for HIV RNA by both NAT tests. The 2 recipients of the day -4 platelets tested HIV RNA an d p24 antigen positive. The recipient of the day -11 platelets could not be tested because he had died. HIV NAT would have prevented transmission of H IV had it been available at the time of this donor's HIV seroconversion.