Busch M P, Valinsky J E, Paglieroni T, Prince H E, Crutcher G J, Gjerset G F, Operskalski E A, Charlebois E, Bianco C, Holland P V
Irwin Memorial Blood Centers, San Francisco, California.
Transfusion. 1994 Mar;34(3):192-7. doi: 10.1046/j.1537-2995.1994.34394196614.x.
The recent recognition of idiopathic CD4+ T-lymphocytopenia (ICL) had led to concern that an unknown immunodeficiency virus may be transmissible by transfusion.
To evaluate the prevalence and significance of low CD4+ values among blood donors, CD4+ data on 2030 blood donors who were negative for antibody to human immunodeficiency virus type 1 (HIV-1) were compiled. Those with CD4+ values below ICL cutoffs (< 300 CD4+ T cells/microL, or < 20% CD4+ T cells) were recalled for follow-up investigations. Serial CD4+ data on 55 homosexual men who seroconverted during prospective follow-up and data on 139 anti-HIV-1-positive blood donors initially evaluated in 1986 were reviewed as well.
Five seronegative donors (0.25%) had absolute CD4+ counts < 300 cells per microL and/or < 20 percent. On follow-up, all five donors had immunologic findings within normal ranges, lacked HIV risk factors, and tested negative for HIV types 1 and 2 and human T-lymphotropic virus type I and II infections by antibody and polymerase chain reaction assays. Four of five donors reported transient illness shortly after their low CD4+ count donations. The median interval from HIV-1 seroconversion to an initial CD4+ value below ICL CD4+ cutoffs was 63 months for infected homosexual men. Of 139 HIV-1-infected blood donors studied 1 to 2 years after seropositive donations, 34 (24%) had CD4+ counts < 300 cells per microL and/or < 20 percent.
Low CD4+ counts are rare among anti-HIV-1-negative volunteer blood donors and are generally associated with transient illnesses. If any unknown virus progresses similarly to HIV-1, CD4+ count donor screening would be a poor surrogate for its detection.
最近对特发性CD4+ T淋巴细胞减少症（ICL）的认识引发了人们对一种未知免疫缺陷病毒可能通过输血传播的担忧。
为评估献血者中CD4+值偏低的患病率及意义，收集了2030名1型人类免疫缺陷病毒（HIV-1）抗体阴性献血者的CD4+数据。对CD4+值低于ICL临界值（<300个CD4+ T细胞/微升，或<20% CD4+ T细胞）的献血者进行召回随访调查。还回顾了55名在前瞻性随访期间血清转化的同性恋男性的连续CD4+数据，以及1986年最初评估的139名抗HIV-1阳性献血者的数据。
5名血清阴性献血者（0.25%）的绝对CD4+计数<300个细胞/微升和/或<20%。随访时，所有5名献血者的免疫指标均在正常范围内，无HIV危险因素，通过抗体和聚合酶链反应检测，HIV-1和2型以及人类嗜T淋巴细胞病毒I型和II型感染均为阴性。5名献血者中有4名报告在CD4+计数偏低献血后不久出现短暂疾病。感染的同性恋男性从HIV-1血清转化到首次CD4+值低于ICL CD4+临界值的中位间隔时间为63个月。在血清学阳性献血后1至2年研究的139名HIV-1感染献血者中，34名（24%）的CD4+计数<300个细胞/微升和/或<20%。
在抗HIV-1阴性的志愿献血者中，CD4+计数偏低情况罕见，且通常与短暂疾病相关。如果任何未知病毒的进展与HIV-1相似，通过CD4+计数进行献血者筛查将很难检测到该病毒。
