Noninfectious transfusion of platelets donated before detection of human immunodeficiency virus RNA in plasma

Abstract

It is unknown whether human immunodeficiency virus (HIV) can be transmitted via blood products donated after primary HIV-1 infection before the detection of viral RNA in plasma. From a 39-year-old repeat donor, double plateletpheresis donations were collected on Days 4 and 18 after the presumptive date of primary HIV-1 infection. The former apheresis donations tested negative for the presence of HIV and were transfused to two patients, whereas the latter donation tested positive by reverse transcription-polymerase chain reaction (RT-PCR) but not in antibody screening and was not released for transfusion. One of the recipients of the Day 4 apheresis donation died of unrelated reasons and could therefore not be tested. The second recipient did not develop HIV-1 infection and has remained negative for the presence of all HIV markers over a period of 7.5 months after the receipt of the apheresis unit. In the donor, qualitative and quantitative RT-PCR as well as an antibody-antigen combination assay were observed to be positive on Day 18. In contrast, the HIV antibody screening test became positive for the first time on Day 25. Transmission of HIV-1 may not occur during the very early stage of infection.