Gürtler L G, Eberle J, Bader L
Max-von-Pettenkofer-Institut für Hygiene und Medizinische Mikrobiologie der Ludwig-Maximilians-Universität München.
Infusionsther Transfusionsmed. 1994 Aug;21 Suppl 1:7-10.
Estimating the risk of HIV transmission by blood or inactivated plasma transfusion. A discussion of the methods and techniques for the diagnosis of HIV infection in blood donors.
Reports in German and English on this topic as well as own experiences of the authors.
No specific selection criteria.
Transfusion associated HIV infection may be prevented by donor selection, the very efficient anti-HIV testing, by p24-antigen testing that may detect some anti-HIV negative donations especially during the early time of seroconversion and by more recent introduced techniques like polymerase chain reaction (PCR) and signal amplification assay (SAA). PCR and SAA are under development and until now not sensitive and specific enough to contribute significantly to an earlier detection of HIV infected blood. Procedures for the inactivation of HIV in plasma or whole blood have been described. Until now use of psoralens, methylene blue or direct UV irradiation may reduce viral load but have not definitely been proven by clinical trials to be 100% efficient.
To minimize transfusion associated HIV infection in future years reduction of total amount of transfused units, restriction to regional donor recruiting and further refinement of tests will be necessary. A 100% safety of blood transfusion for infectious agent cannot be achieved, especially considering new agents and further spread of until now geographically restricted viruses.
评估通过输血或输注灭活血浆传播HIV的风险。讨论献血者中HIV感染的诊断方法和技术。
德语和英语关于该主题的报告以及作者自身的经验。
无特定选择标准。
通过献血者筛选、高效的抗HIV检测、p24抗原检测（可检测到一些抗HIV阴性的献血，尤其是在血清转化早期）以及最近引入的技术如聚合酶链反应（PCR）和信号放大检测法（SAA），可预防输血相关的HIV感染。PCR和SAA尚在研发中，目前其敏感性和特异性还不足以对早期检测HIV感染血液做出显著贡献。已有关于血浆或全血中HIV灭活的程序描述。目前，使用补骨脂素、亚甲蓝或直接紫外线照射可降低病毒载量，但尚未通过临床试验明确证明其100%有效。
为在未来几年将输血相关的HIV感染降至最低，有必要减少输血总量、限制在当地招募献血者并进一步完善检测方法。尤其是考虑到新的病原体以及目前受地理限制的病毒的进一步传播，无法实现输血针对感染因子的100%安全性。
