Archives of Virology

, 156:2085 | Cite as

Genomic detection of human immunodeficiency virus (HIV) by nucleic acid amplification test in a frequent platelet donor during the pre-seroconversion period

Brief Report


Since serological donor-screening tests for HIV were introduced in 1985, the safety of donated blood components has improved dramatically. However, these tests do not completely prevent the risk of transfusion-associated HIV infection related to the use of blood donated during the pre-seroconversion window period. Testing based on nucleic acid amplification is being implemented to screen for HIV-infected blood donated during this period, which has reduced the probability of transmitting HIV through transfusion by shortening the window period. This article describes a case of acute HIV-1 infection, detected using a nucleic acid amplification test (NAT) in a repeat blood donor who donated during the pre-seroconversion window period and whose antigen and anti-HIV antibody expression was observed after molecular marker detection. In addition, the possible route of infection is discussed based on the patient’s history, and finally, the need for NAT technology for blood donor screening is emphasized.


Nucleic acid testing p24 Window period HIV diagnosis Blood donation 


  1. 1.
    Ling AE, Robbins KE, Brown TM, Dunmire V, Thoe SY, Wong SY, Leo YS, Teo D, Gallarda J, Phelps B, Chamberland ME, Busch MP, Folks TM, Kalish ML (2000) Failure of routine HIV-1 tests in a case involving transmission with preseroconversion blood components during the infectious window period. JAMA 284(2):210–214PubMedCrossRefGoogle Scholar
  2. 2.
    Bush MP, Satten GA (1997) Time course of viremia and antibody seroconversion following human immunodeficiency virus exposure. Am J Med 102:117–124CrossRefGoogle Scholar
  3. 3.
    Petersen LR, Satten GA, Dodd R, Busch M, Kleinman S, Grindon A, Lenes B (1994) Duration of time from onset of human immunodeficiency virus type 1 infectiousness to development of detectable antibody. The HIV Seroconversion Study Group. Transfusion 34(4):283–289PubMedCrossRefGoogle Scholar
  4. 4.
    Busch MP, Glynn S, Stramer S, Strong M, Caglioti S, Wright D, Pappalardo B, Kleinman S (2005) A new strategy for estimating risks of transfusion-transmitted viral infections based on rates of detection of recently infected donors. Transfusion 45:254–264PubMedCrossRefGoogle Scholar
  5. 5.
    Phelps R, Robbins K, Liberti T, Machuca A, Leparc G, Chamberland M, Kalish M, Hewlewtt I, Folks T, Lee L, McKenna M (2004) Window-period human immunodeficiency virus transmission to two recipients by an adolescent blood donor. Transfusion 44:929–933PubMedCrossRefGoogle Scholar
  6. 6.
    Wendel S, Fachini R, Levi J, Ghaname J, Mendonça M, Almeida C, DiPietro A (2002) A single window-period donation detected by human immunodeficiency vírus p24 antigen after 5 years of routine screening in a group of Brazilian blood Banks. Vox sanguinis 83:309–312PubMedCrossRefGoogle Scholar
  7. 7.
    Van de Laar MJ, Likatavicius G, Stengaard AR, Donoghoe MC (2008) HIV/AIDS surveillance in Europe: update 2007. Euro Surveill 13(50)pii:19066Google Scholar
  8. 8.
    Kilmarx PH (2009) Global epidemiology of HIV. Curr Opin HIV AIDS 4(4):240–246PubMedCrossRefGoogle Scholar
  9. 9.
    Scully C, Greenspan J (2006) Human immunodeficiency virus (HIV) transmission in dentistry. J Dent Res 85(9):794–800PubMedCrossRefGoogle Scholar
  10. 10.
    McCarthy GM, Ssali CS, Bednarsh H, Jorge J, Wangrangsimakul K, Page-Shafer K (2002) Transmission of HIV in the dental clinic and elsewhere. Oral Diseases 8(Suppl 2):126–135PubMedCrossRefGoogle Scholar
  11. 11.
    Hutin YJ, Harpaz R, Drobenniuc J (1999) Injections given in healthcare setting as a major source of acute hepatitis B in Moldona. Int J Epidemiol 28:782–786PubMedCrossRefGoogle Scholar
  12. 12.
    Kane M (1998) Unsafe injections. Bull World Health Organ 76:99–100PubMedGoogle Scholar
  13. 13.
    Hersh BS, Popovici F, Jezek Z (1993) Risk Factors of HIV infections among abandoned Romanian children. AIDS 7:1617–1624PubMedCrossRefGoogle Scholar
  14. 14.
    Bautista LE, Orostegui M (1997) Dental care associated with an outbreak of HIV infection among dialysis patients. Rev Panam Salud Publica 2:194–202PubMedCrossRefGoogle Scholar
  15. 15.
    DePaola D, Howell H, Baker CG, Boy-Lefevre ML, Hull P, Holmstrup P, Jerolimov V, Hardwick K, Lamster IB, Lopez NL (2002) Research and the dental student. Eur J Dental Educ 6(Suppl 3):45–51CrossRefGoogle Scholar
  16. 16.
    Kohn WG, Collins AS, Cleveland JL, Harte JA, Eklund KJ, Malvitz DM (2001) Guidelines for infection control in dental Health-Care setting. MMWR 52(RR-17):1–61Google Scholar
  17. 17.
    Nasir EF, Astrom AN, David J, Ali RW (2009) Utilization of dental health care services in context of the HIV epidemic—a cross-sectional study of dental patients in the Sudan. BMC Oral Health 9:30PubMedCrossRefGoogle Scholar
  18. 18.
    Piquet Y, Ivanovic Z, Laperche S, Pillonel J, Cristol G, Jeanne M, Neaus D, Fleury H, Boiron JM (2007) Nucleic acid amplification testing detecting of an HIV-1 infection in a blood donor during the preseroconversion window period. Transfusion 17:147–148CrossRefGoogle Scholar
  19. 19.
    Ly TD, Ebel A, Faucher V, Fihman V, Laperche S (2007) Could the new HIV combined p24 antigen and antibody assays replace p24 antigen specific assays? J Virol Meth 143:86–94CrossRefGoogle Scholar
  20. 20.
    Pandori M, Branson B (2010) 2010 HIV Diagnostics conference. Expert Rev Anti Infect Ther 8(6):631–633PubMedCrossRefGoogle Scholar
  21. 21.
    Berrey MM, Schlaker T, Collier AC, Shea T, Brodie SJ, Mayers D, Coombs R, Krieger J, Chun TW, Fauci A, Self SG, Corey L (2001) Treatment of primary human immunodeficiency virus type 1 infection with potent antiretroviral therapy reduces frequency of rapid progression to AIDS. J Infect Dis 183:1466–1475PubMedCrossRefGoogle Scholar
  22. 22.
    Ly TD, Laperche S, Brennan C, Vallari A, Ebel A, Hunt J, Martin L, Daghfal D, Schochetman G, Devare S (2004) Evaluation of the sensitivity and specificity of six HIV combined p24 antigen and antibody assays. J Virol Meth 122:185–194CrossRefGoogle Scholar
  23. 23.
    Sudha T, Lakshmi V, Teja VD (2006) Western blot profile in HIV infection. Ind J Dermatol Venereol Leprol 72(5):357–360CrossRefGoogle Scholar
  24. 24.
    Duri K, Müller F, Gumbo FZ, Kurewa NE, Rusakaniko S, Chirenje MZ, Mapingure MP, Stray-Pedersen B (2011) Human Immunodeficiency Virus (HIV) types Western blot (WB) band profiles as potential surrogate markers of HIV disease progression and predictors of vertical transmission in a cohort of infected but antiretroviral therapy naïve pregnant women in Harare, Zimbabwe. BMC Infect Dis 11:7PubMedCrossRefGoogle Scholar
  25. 25.
    Tobler LH, Kaufman E, Gefter N, Schable C, Busch MP (1997) Use of human immunodeficiency virus (HIV) type 1 and 2 recombinant strip immunoblot assay to resolve enzyme immunoassay anti-HIV-2-repeatably reactive samples after anti-HIV-1/2 combination enzyme immunoassay screening. Transfusion 37(9):921–925PubMedCrossRefGoogle Scholar
  26. 26.
    Ravanshad M, Sabahi F, Mahboudi F, Kazemnejad A (2006) Evaluation of a new dot blot assay for confirmation of human immunodeficiency virus type 1 and 2 infections using recombinant p24, gp41, gp120 and gp36 antigens. Saudi Med J 27(1):31–36PubMedGoogle Scholar
  27. 27.
    Stramer SL (2002) US NAT yield. Where are we after 2 years? Transf Med 12:243–253CrossRefGoogle Scholar
  28. 28.
    Grant PR, Busch MP (2002) Nucleic acid amplification technology methods used in blood donor screening. Transf Med 12:229–242CrossRefGoogle Scholar
  29. 29.
    Roth WK, Weber M, Seifried E (1999) Feasibility and efficacy of routine PCR screening of blood donations for hepatitis C virus, hepatitis B virus and HIV-1 in a blood-bank setting. Lancet 353:359–363PubMedCrossRefGoogle Scholar
  30. 30.
    Aprili G, Gandini G, Piccoli P, Bressan F, De Gironcoli M, Mazzi R, Parisi S, Gessoni G, Marchiori G, Franchini M (2003) Detection of an early HIV-1 infection by HIV RNA testing in an Italian blood donor during the preseroconversion window period. Transfusion 43:848–852PubMedCrossRefGoogle Scholar
  31. 31.
    Candotti D, Richetin A, Cant B, Temple J, Sims C, Reeves I, Barbara J, Allain J-P (2003) Evaluation of a transcription-mediated amplification-based HCV and HIV-1 duplex assay for screening individual blood donations: a comparison with a minipool testing system. Transfusion 43:215–225PubMedCrossRefGoogle Scholar
  32. 32.
    Najioullah F, Barlet V, Renaudier P, Guitton C, Crova P, Guérin J-C, Peyramond D, Trabaud M-A, Coudurier N, Tardy J-C, André P (2004) Failure and success of HIV tests for the prevention of HIV-1 transmission by blood and tissue donations. J Med Virol 73:347–349PubMedCrossRefGoogle Scholar
  33. 33.
    Delwart EL, Kalmin ND, Jones TS, Ladd DJ, Foley B, Tobler LH, Tsui RC, Busch MP (2004) First report of human immunodeficiency virus transmission via an RNA-screened blood donation. Vox Sanguinis 86:171–177PubMedCrossRefGoogle Scholar
  34. 34.
    Tabor E, Epstein JS (2002) NAT screening of blood and plasma donations: evolution of technology and regulatory policy. Transfusion 42(9):1230–1237PubMedCrossRefGoogle Scholar
  35. 35.
    Roth WK, Weber M, Buhr S (2002) Yield of HCV and HIV-1 NAT after screening of 3, 6 million blood donations in central Europe. Transfusion 42:862–868PubMedCrossRefGoogle Scholar
  36. 36.
    Busch MP, Wright DJ, Hirschkorn DF, Baggett D (2001) Sensitivity of 1st and 2nd generation HCV antigen assays versus nucleic acid testing (NAT) for detection of ramp-up phase HCV detection (abstract S4-030ª). Transfusion 41(Suppl)3sGoogle Scholar
  37. 37.
    Busch MP, Dodd RY (2000) NAT and blood safety: what is the paradigm? Transfusion 40:1157–1160PubMedCrossRefGoogle Scholar
  38. 38.
    Schreiber GB, Busch MP, Kleinman SH, Korelitz JJ (1996) The risk of transfusion-transmitted viral infections. N Engl J Med 334:1685–1690PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Laboratório de Virologia Humana, Instituto de Patologia Tropical e Saúde PúblicaUniversidade Federal de GoiásGoiâniaBrasil
  2. 2.Central Goiana de Sorologia, Imuno-hematologia e Biologia MolecularGoiâniaBrasil
  3. 3.Hospital Materno-InfantilGoiâniaBrasil

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