LETTER
Making the Blood Supply Safer
Dietmar Fuchs;
Gunter Weiss; and
Helmut Wachter
1 April 1993 | Volume 118 Issue 7 | Pages 574-575
TO THE EDITOR:
Heymann and coworkers [1] suggest that the risk for infection from blood transfusion has become acceptably low 11 years after the acquired immunodeficiency syndrome (AIDS) was first described. Without doubt, blood transfusion is safer today than in the early 1980s, although a residual risk for human immunodeficiency virus (HIV) transmission still exists [2]. However, the newly recognized patients who have T-lymphocytopenia but are negative for HIV types 1 and 2 remind us that a newly emerging pathogen is still able to penetrate the blood supply.
Specific tests for known pathogens may miss evolving ones. A multispecific "gatekeeper test" would reduce the residual risk of unknown pathogens. Since 1986, neopterin screening of blood donations has been done in the Austrian Tyrol to detect potentially hazardous donations [3]. In a high percentage of acute virus infections, including HIV, neopterin levels increase even before antibody formation [4, 5]. Three quarters of asymptomatic persons with HIV infection have increased neopterin levels [3], and these levels are even higher during acute HIV infection [5]. We conclude that the risk of transmitting new pathogens may be reduced using neopterin screening.
1. Heymann SJ, Brewer TF, Fineberg HV, Wilson ME. How safe is safe enough? New infections and the U.S. blood supply. Ann Intern Med. 1992; 117:611-3.
2. Conley LJ, Holmberg SD. Transmission of AIDS from blood screened negative for antibody to the human immunodeficiency virus. N Engl J Med. 1992; 326:1499.
3. Honlinger M, Fuchs D, Hausen A, et al. Serum-Neopterinbestimmung zur zusatzlichen Sicherung der Bluttransfusion. Dtsch Med Wochenschr. 1989; 114:172-6.
4. Fuchs D, Hausen A, Reibnegger G, et al. Neopterin as a marker for activated cell-mediated immunity: application in HIV infection. Immunol Today. 1988; 9:150-5.
5. Zangerle R, Schonitzer D, Fuchs D, Most J, Dierich MP, Wachter H. Reducing HIV transmission by seronegative blood. Lancet. 1992; 340: 130-1.
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