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Screening of blood donors for idiopathic CD4 + T‐lymphocytopenia
Author(s) -
Busch M.P.,
Valinsky J.E.,
Paglieroni T.,
Prince H.E.,
Crutcher G.J.,
Gjerset G.F.,
Operskalski E.A.,
Charlebois E.,
Bianco C.,
Holland P.V.,
Petersen L.R.,
Hollingsworth C.G.,
Mosley J.W.
Publication year - 1994
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1046/j.1537-2995.1994.34394196614.x
Subject(s) - lymphocytopenia , seroconversion , medicine , human t lymphotropic virus , immunology , antibody , serology , viral disease , human immunodeficiency virus (hiv) , immunopathology , blood donations , leukopenia , virology , lymphocyte , chemotherapy , myelopathy , psychiatry , spinal cord
Background: The recent recognition of idiopathic CD4 + T‐lymphocytopenia (ICL) had led to concern that an unknown immunodeficiency virus may be transmissible by transfusion. Study Design and Methods: To evaluate the prevalence and significance of low CD4 + values among blood donors, CD4 + data on 2030 blood donors who were negative for antibody to human immunodeficiency virus type 1 (HIV‐1) were compiled. Those with CD4 + values below ICL cutoffs (< 300 CD4 + T cells/μL, or < 20% CD4 + T cells) were recalled for follow‐up investigations. Serial CD4 + data on 55 homosexual men who seroconverted during prospective follow‐up and data on 139 anti‐HIV‐1‐positive blood donors initially evaluated in 1986 were reviewed as well. Results: Five seronegative donors (0.25%) had absolute CD4 + counts < 300 cells per μL and/or < 20 percent. On follow‐up, all five donors had immunologic findings within normal ranges, lacked HIV risk factors, and tested negative for HIV types 1 and 2 and human T‐lymphotropic virus type I and II infections by antibody and polymerase chain reaction assays. Four of five donors reported transient illness shortly after their low CD4 + count donations. The median interval from HIV‐1 seroconversion to an initial CD4 + value below ICL CD4 + cutoffs was 63 months for infected homosexual men. Of 139 HIV‐1‐infected blood donors studied 1 to 2 years after seropositive donations, 34 (24%) had CD4 + counts < 300 cells per μL and/or < 20 percent. Conclusion: Low CD4 + counts are rare among anti‐ HIV‐1‐negative volunteer blood donors and are generally associated with transient illnesses. If any unknown virus progresses similarly to HIV‐ 1, CD4 + count donor screening would be a poor surrogate for its detection.