Transfusion–Transmitted Viruses

Extract

The number and variety of viruses that have been proven to be transmitted by the transfusion of blood and blood products continue to increase. Among the viruses that are familiar to the clinical laboratory scientist are those for which the blood supply is currently tested: human immunodeficiency virus human immunodeficiency virus 1/2 (HIV 1/2), human T-cell lymphotropic virus (HTLV) I and II, hepatitis C virus (HCV), hepatitis B virus (HBV), and, in some cases, cytomegalovirus (CMV). The transmission of West Nile virus (WNV) by both transfusion and transplantation has recently emerged as a concern. Donor testing for WNV was implemented as soon as a test for its detection was approved in the summer of 2003. Additionally, the testing of donor units for hepatitis A virus (HAV) and parvovirus B19 is under review and is likely to be implemented in the near future. Donors who have either resided or traveled in the United Kingdom (UK)or continental Europe for an accumulation of three months between the years 1980 and 1996, or injected bovine insulin from the UK, are deferred from blood donation in the United States (U.S.) because they are considered to be at risk for variant Crutzfeldt-Jakob Disease (vCJD), a form of spongiform encephalopathy that may be transfusion-transmissible.

Several other viruses are either transfusion-transmitted or suspected of being so. SEN virus (SEN-V) has recently been investigated in transfusion-associated hepatitis. Transfusion-transmitted virus (TTV), an aptly named viral agent, is prevalent in the donor population and may be associated with chronic alanine aminotransferase…

ABBREVIATIONS: AABB = American Association of Blood Banks; ALT = alanine aminotransferase; AMT = aminomethyl trimethyl psoralen; anti-HBc = anti-hepatitis B core antigen; BPV = bovine papillomavirus; BSE = bovine spongiform encephalopathy; CDC = Centers for Disease Control; CJD = Crutzfeldt-Jakob disease; CMV = cytomegalovirus; DMMB = dimethymethylene blue; EBV = Epstein-Barr virus; FDA = Food and Drug Administration; FRALE = fangible anchor length effectors; GBV-C = hepatitis GB virus; GGT = gamma glutamyl transferase; HAV = hepatitis A virus; HbsAg = hepatitis B surface antigen; HBV = hepatitis B virus; HCV = hepatitis C virus; HGV = hepatitis G virus; HHV = human herpes virus; HIV = human immunodeficiency virus; HPV = human papillomavirus; HTLV = human T-cell lymphotropic virus I and II; NAT = nucleic acid testing; NIH = National Institutes of Health; REDS = Retrovirus Epidemiology Donor Study; S-D = solvent-detergent process; SD-FFP = solvent-detergent fresh frozen plasma; SEN-V = SEN virus; TNBP = tri (n-butyl) phosphate; TTV = transfusion-transmitted virus; UVA = ultraviolet A; vCJD = variant Crutzfeldt-Jakob disease; WNV = West Nile virus.