Busch M P, Operskalski E A, Mosley J W, Lee T H, Henrard D, Herman S, Sachs D H, Harris M, Huang W, Stram D O
Irwin Memorial Blood Centers, University of California, San Francisco, USA.
J Infect Dis. 1996 Jul;174(1):26-33. doi: 10.1093/infdis/174.1.26.
One hundred thirty-two recipients of blood components that retrospectively tested positive for antibody to human immunodeficiency virus type 1 (anti-HIV-1) were identified. Fourteen (11%) remained seronegative throughout follow-up. Donor and recipient characteristics that could have influenced transmission were examined. Attributes did not differ for infected and uninfected recipients. Peripheral blood mononuclear cells (PBMC) from uninfected recipients were HIV-1-negative by DNA amplification and culture but were susceptible to in vitro infection. Transmitting and nontransmitting donors at donation differed only for HIV-1 RNA positivity. By immunocapture reverse transcriptase-polymerase chain reaction, 6 of 11 transmitters and 0 of 11 nontransmitters tested RNA-positive (P = .02). A more sensitive quantitative RNA assay detected RNA in all donation sera, but median levels were higher in transmitting than nontransmitting sera (P = .01). Median CD4 cell counts were lower for transmitting than nontransmitting donors at enrollment (P = .02). Level of viremia is an important determinant of HIV infection by blood transfusion.
我们识别出132名血液成分接受者，其对1型人类免疫缺陷病毒（抗HIV-1）抗体的回顾性检测呈阳性。14名（11%）在整个随访期间保持血清学阴性。我们检查了可能影响传播的供者和受者特征。感染和未感染受者的特征并无差异。未感染受者的外周血单个核细胞（PBMC）经DNA扩增和培养后HIV-1呈阴性，但易受体外感染。献血时具有传播性和无传播性的供者仅在HIV-1 RNA阳性方面存在差异。通过免疫捕获逆转录酶-聚合酶链反应，11名有传播性的供者中有6名检测RNA呈阳性，11名无传播性的供者中0名检测RNA呈阳性（P = 0.02）。一种更灵敏的定量RNA检测法在所有献血血清中均检测到RNA，但有传播性血清中的RNA中位水平高于无传播性血清（P = 0.01）。入组时，有传播性供者的CD4细胞计数中位数低于无传播性供者（P = 0.02）。病毒血症水平是输血导致HIV感染的一个重要决定因素。
