Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo 05403-000, Brazil.
Laboratory of Medical Investigation in Pathogenesis and Targeted Therapy in Oncoimmunohematology (LIM-31), Department of Hematology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-000, Brazil.
Viruses. 2022 Oct 8;14(10):2214. doi: 10.3390/v14102214.
Prevention of HIV acquisition by blood transfusion from its emergence to the present day is reviewed, and current challenges are delineated. The experience of Fundação Pró-Sangue/Hemocentro de São Paulo, Brazil, is highlighted in the quest for improvements in blood safety and the evolution of increasingly sensitive and specific screening tests. Concerns and establishing stringent criteria in the screening of potential blood donors are emphasized, and the current criteria for identifying and deferring candidates at high risk of acquiring sexually transmitted diseases are summarized. Future challenges relate to the identification of donors with unreported use of antiretroviral drugs for prophylaxis against possible HIV exposure or for treatment of an HIV infection whose viral expression is undetectable by current analyses. There is a need to better understand the motivation of HIV-exposed donors and to educate them about the risk of transfusion-mediated HIV transmission despite having low or undetectable viral loads. In situations in which traditional HIV RNA or antibody detection assays remain negative, more sensitive analyses are needed to identify potential donors at risk for HIV transmission.
本文回顾了从艾滋病出现至今，通过输血预防艾滋病的发展历程，并阐述了当前所面临的挑战。本文重点介绍了巴西圣保罗血库基金会的经验，该基金会致力于提高血液安全性，并不断改进检测方法，以提高检测的灵敏度和特异性。本文强调了在筛查潜在献血者时的注意事项和严格标准，并总结了目前用于识别和推迟高风险性病传播疾病候选人的标准。未来的挑战涉及到识别那些未报告使用抗逆转录病毒药物进行预防可能的 HIV 暴露或治疗 HIV 感染的献血者，因为目前的分析方法无法检测到这些病毒的表达。有必要更好地了解 HIV 暴露献血者的动机，并教育他们尽管病毒载量低或无法检测到，但仍存在经输血传播 HIV 的风险。在传统的 HIV RNA 或抗体检测仍为阴性的情况下，需要更敏感的分析方法来识别有潜在 HIV 传播风险的供者。
