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Transfusion‐transmitted human T ‐lymphotropic virus T ype I infection in a U nited S tates military emergency whole blood transfusion recipient in A fghanistan, 2010
Author(s) -
Hakre Shilpa,
Manak Mark M.,
Murray Clinton K.,
Davis Kenneth W.,
Bose Meera,
Harding Aaron J.,
Maas Peter R.,
Jagodzinski Linda L.,
Kim Jerome H.,
Michael Nelson L.,
Rentas Francisco J.,
Peel Sheila A.,
Scott Paul T.,
Tovanabutra Sodsai
Publication year - 2013
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.12101
Subject(s) - medicine , blood transfusion , whole blood , donation , blood donations , blood bank , blood donor , virology , emergency medicine , immunology , economics , economic growth
Background The U nited S tates introduced human T ‐lymphotropic virus T ype I ( HTLV ‐ I ) screening of blood donors in 1988. The US military uses freshly collected blood products for life‐threatening injuries when available stored blood components in theater have been exhausted or when these components are unsuccessful for resuscitation. These donors are screened after donation by the D epartment of D efense ( DoD ) retrospective testing program. All recipients of blood collected in combat are tested according to policy soon after and at 3, 6, and 12 months after transfusion. Case Report A 31‐year‐old US A rmy soldier tested positive for HTLV ‐ I 44 days after receipt of emergency blood transfusions for severe improvised explosive device blast injuries. One donor's unit tested HTLV ‐ I positive on the DoD ‐mandated retrospective testing. Both the donor and the recipient tested reactive with enzyme immunoassay and supplemental confirmation by HTLV ‐ I W estern blot. The donor and recipient reported no major risk factors for HTLV ‐ I . Phylogenetic analysis of HTLV ‐ I sequences indicated C osmopolitan subtype, S ubgroup B infections. Comparison of long terminal repeat and env sequences revealed molecular genetic linkage of the viruses from the donor and recipient. Conclusion This case is the first report of transfusion transmission of HTLV ‐ I in the US military during combat operations. The emergency fresh whole blood policy enabled both the donor and the recipient to be notified of their HTLV ‐ I infection. While difficult in combat, predonation screening of potential emergency blood donors with F ood and D rug A dministration–mandated infectious disease testing as stated by the DoD H ealth A ffairs policy should be the goal of every facility engaged with emergency blood collection in theater.