Premium
Transmission of human immunodeficiency virus T ype‐1 by fresh‐frozen plasma treated with methylene blue and light
Author(s) -
Álvarez Manuel,
LuisHidalgo Mar,
Bracho María Alma,
Blanquer Amando,
Larrea Luis,
Villalba José,
Puig Nieves,
Planelles Dolores,
Montoro José,
GonzálezCandelas Fernando,
Roig Roberto
Publication year - 2016
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.13409
Subject(s) - fresh frozen plasma , virology , antibody , blood donor , medicine , virus , buffy coat , window period , human immunodeficiency virus (hiv) , platelet , immunology , serology
BACKGROUND The risk of transfusion‐transmitted infection (TTI) has been minimized by introduction of nucleic acid testing (NAT) and pathogen inactivation (PI). This case report describes transmission of human immunodeficiency virus Type 1 (HIV‐1) to two recipients despite these measures. STUDY DESIGN AND METHODS In March 2009 a possible TTI of HIV‐1 was identified in a patient that had received pooled buffy coat platelet concentrate (BC‐PLT) in November 2005. The subsequent lookback study found two more patients who had received methylene blue (MB)‐treated fresh‐frozen plasma (FFP) and red blood cells (RBCs) from the same donation. In November 2005 the donor had tested negative for both HIV antibodies and HIV‐1 RNA by 44 minipool (44 MP) NAT. Repository samples of this donation and samples from the recipients were used for viral load (VL) and sequence analysis. RESULTS HIV‐1 RNA was detectable by individual donation (ID)‐NAT in the repository sample from the 2005 window period donation and a VL of 135 copies/mL was measured. HIV‐1 infection was confirmed in both recipients of both BC‐PLT (65 mL of plasma) and MB‐FFP (261 mL of plasma), but not in the patient that had received 4‐week‐old RBCs (20 mL of plasma). The sequence analysis revealed a close phylogenetic relationship between the virus strains isolated from the donor and recipients, compatible with TTI. CONCLUSIONS Approximately 17,600 and 4400 virions in the MB‐FFP and BC‐PLT were infectious, but 1350 virions in the RBCs were not. ID‐NAT would have prevented this transmission, but the combination of MP‐NAT and MB‐PI did not.