Human T-cell leukemia virus type II infection frequently goes undetected in
contemporary US blood donors
B Hjelle, C Wilson, S Cyrus, P Bradshaw, J Lo, C Schammel, T Wiltbank and S Alexander
Department of Pathology, University of New Mexico School of Medicine,
Albuquerque 87131.
Serologic screening for human T-cell leukemia virus type I (HTLV-I)
infection was begun in US blood banks with the licensure of enzyme- linked
immunosorbent assays (ELISA) in December 1988. We examined the donation
histories of the first 60 Western blot (WB)-confirmed HTLV- I/II positive
donors to one blood center and found 8 had made 16 previous donations that
scored negative on the screening ELISA. All 16 donations had ELISA
absorbance below the cutoff for a positive assay, but still well above that
of the average donation (17.6% +/- 5.7% of the cutoff). In a more extensive
study, 17 donations from a total of 61,752 at six blood centers were both
ELISA-positive and WB-positive for HTLV-I (4) or HTLV-II (13), and 218
samples had ELISA absorbance greater than 50% of the ELISA cutoff. One
hundred seventy-eight of the 218 were tested further by WB and 11 were
found positive. All 11 positives were confirmed by polymerase chain
reaction; 10 had HTLV-II and 1 had HTLV-I. Thus, the HTLV-I-based screening
ELISA missed at least 10 of 23, or 43% (95% confidence interval, 23% to
66%), of HTLV- II infections, compared with 1 of 5, or 20%, of HTLV-I
infections.
Volume 81,
Issue 6,
pp. 1641-1644,
03/15/1993
Copyright © 1993 by The American Society of Hematology
