Petricciani J C, Epstein J S
FDA Center for Drugs and Biologics, Bethesda, MD 20892.
Public Health Rep. 1988 May-Jun;103(3):236-41.
Present safeguards for the blood supply consist of three tiers of protection: donor deferral based on a donor's history of risk factors, confidential exclusion of blood units from donors with self-admitted risk factors, and testing of the blood itself. Before the discovery of the AIDS virus in 1983 and 1984, there was no specific test relevant to AIDS that could be used to help improve the safety of the blood supply. The first step was intensified efforts, based on what was then known of the epidemiology of the disease, to take donor histories to identify risk factors. The first specific tests were for the detection of antibodies to the virus and came into use in 1985. The general features of AIDS are described, together with the scientific rationale for the various types of laboratory tests, those for the virus itself, antigens, antibodies, the genetic material of the virus, and T4 lymphocytes. General characteristics of the tests are reviewed. Since testing began, about 30 million units each of blood and plasma have been screened. More than 3,000 infected persons in the blood donor group have been identified as HIV-antibody positive. Thirteen cases of transfusion-associated infection have been documented. They are believed to have occurred because a detectable level of antibodies had not yet formed in the infected donors. Currently, such transmission is thought to occur once in about 40,000 to 250,000 donations, a dramatic improvement from 1983.
基于献血者风险因素历史记录的献血者延期、对自我承认有风险因素的献血者的血液单位进行保密排除以及对血液本身进行检测。在1983年和1984年发现艾滋病病毒之前，没有可用于帮助提高血液供应安全性的与艾滋病相关的特定检测方法。第一步是根据当时已知的疾病流行病学情况，加大力度采集献血者病史以识别风险因素。首批特定检测是用于检测病毒抗体的，于1985年开始使用。本文描述了艾滋病的一般特征，以及各类实验室检测（针对病毒本身、抗原、抗体、病毒遗传物质和T4淋巴细胞的检测）的科学原理。还回顾了检测的一般特点。自检测开始以来，已筛查了约3000万单位的血液和血浆。已确定献血者群体中有3000多名感染者的HIV抗体呈阳性。已记录了13例输血相关感染病例。据信这些感染的发生是因为受感染献血者体内尚未形成可检测水平的抗体。目前，这种传播被认为大约每4万至25万次献血中发生一次，与1983年相比有了显著改善。
