Busch MP, Valinski J, Paglieroni T, Prince H, Mosley JW; International Conference on AIDS.

Int Conf AIDS. 1993 Jun 6-11; 9: 92 (abstract no. WS-C11-1).

Irwin Meml Blood Ctrs, San Francisco, CA.

BACKGROUND: Recent definition of idiopathic CD4 T-lymphocytopenia (ICL) has led to concern that an unknown immunodeficiency virus may be transfusion-transmitted. As a result, CD4 screening of donors has been suggested. METHODS: We compiled CD4 data for 2,030 anti-HIV-1-negative blood donors. Donors with CD4 values of < 300 CD4+ cells/ul, or < 20% CD4+ T-cells were recalled for follow-up. We also reviewed serial CD4 data for 58 gay men who seroconverted during prospective follow-up, and data for 133 anti-HIV-1 positive blood donors initially evaluated for CD4 counts in 1986. RESULTS: 5 seronegative donors (0.25%) had absolute CD4 counts < 300 cells/ul (4 donors) and/or < 20% (2 donors). On followup, all 5 donors had immunological findings within normal ranges, lacked retrovirus risk factors, and tested negative for HIV-1/2 and HTLV-I/II infections by antibody and PCR assays. 4/5 had histories of transient illnesses shortly after their low CD4 count donations. For 58 HIV-1 seroconverters, the median interval from seroconversion to a CD4 count < or = ICL cutoffs was 63 months. Of 133 anti-HIV-1-positive donors studied after 2 years, only 28 (21%) had CD4 counts < 300 cells/ul and/or < 20%. Based on these sensitivity/specificity data, the positive predictive value of CD4 screening of donors for detection of an immunodeficiency virus similar to HIV-1 was projected at < 1%. CONCLUSION: If any unknown virus progresses similarly to HIV-1, CD4 donor screening would be a very poor surrogate for its detection. Retrospectively, CD4 screening would also have been a very poor surrogate for HIV-1 infection prior to development of specific HIV-1 screening.

Publication Types:

• Meeting Abstracts

Keywords:

• Blood Donors
• CD4 Lymphocyte Count
• CD4-Positive T-Lymphocytes
• HIV Infections
• HIV Seropositivity
• HIV-1
• HTLV-I Infections
• Homosexuality
• Humans
• Longitudinal Studies
• Male
• Prevalence
• Risk Factors
• T-Lymphocytopenia, Idiopathic CD4-Positive
• epidemiology

Other ID:

• 93336445

UI: 102205823

From Meeting Abstracts