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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

  1. CDC. Prevention of acquired immune deficiency syndrome (AIDS): report of inter-agency recommendations. MMWR 1983;32:101-3.

  2. 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.

  3. 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.

  4. CDC. Update: Public Health Service workshop on human T-lymphotropic virus type III antibody testing--United States. MMWR 1985;34:477-8.

  5. 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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