Update: Revised Public Health Service Definition of Persons Who
Should Refrain from Donating Blood and Plasma -- United States
Since March 1985, blood- and plasma-collection centers in the
United States have used a two-phase screening procedure to decrease
transmission of human T-lymphotropic virus type III (HTLV-III)
through
transfusion of blood or blood products. First, potential donors
are
informed that if they have a risk factor for AIDS they should not
donate (1); second, the blood or plasma of persons accepted as
donors
is screened for antibody to HTLV-III (2,3). The low frequency of
enzyme immunoassay (EIA)-positive tests among blood donors (3,4)
shows
that the deferral criteria have been effective. Interviews with
the
small number of blood donors found infected with HTLV-III, however,
have shown that most have a risk factor for HTLV-III infection;
homosexual contact was the most common risk factor identified (5).
To
further reduce the risk of HTLV-III infection from blood and
plasma,
the U.S. Food and Drug Administration (FDA) has reworded the
donor-deferral recommendations to state that any man who has had
sex
with another man since 1977 should not donate blood or plasma.
This
applies even to men who may have had only a single contact and who
do
not consider themselves homosexual or bisexual.
Reported by Center for Drugs and Biologics, US Food and Drug
Administration; AIDS Br, Div of Viral Diseases, Center for
Infectious
Diseases, CDC.
Editorial Note
Editorial Note: Recommendations to decrease transmission of
HTLV-III
through transfusion of blood or blood products were disseminated in
March 1983 (1) and were rapidly adopted by blood and plasma centers
throughout the United States. These recommendations centered on
informing all blood or plasma donors that people with a risk factor
for AIDS should not donate and asked for voluntary compliance. In
March 1985, the second phase of screening blood and plasma was
instituted with licensure of test kits to detect antibody to
HTLV-III
(2,3). The test kits are both highly sensitive and specific (4),
but
donors with a risk factor for HTLV-III infection continue to be
asked
not to donate blood, since the two-phase screening procedure
provides
additional safety. This revised wording of the deferral
recommendations is intended to inform persons who may have been
infected with HTLV-III through occasional or intermittent
homosexual
activity that they should not donate blood or plasma, even if they
do
not believe they are at risk of having been infected through their
contacts.
References
CDC. Prevention of acquired immune deficiency syndrome (AIDS):
report of inter-agency recommendations. MMWR 1983;32:101-3.
CDC. Provisional Public Health Service inter-agency
recommendations for screening donated blood and plasma for
antibody to the virus causing acquired immunodeficiency
syndrome.
MMWR 1985;34:1-5.
CDC. Results of human T-lymphotropic virus type III test kits
reported from blood collection centers--United States, April
22,-May 19, 1985. MMWR 1985;34:375-6.
CDC. Update: Public Health Service workshop on human
T-lymphotropic virus type III antibody testing--United States.
MMWR 1985;34:477-8.
Schorr JB, Berkowitz A, Cumming PD, Katz AJ, Sandler SG.
Prevalence of HTLV-III antibody in American blood donors.
(Letter) N Engl J Med 1985;313:384-5.
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