Document 0910
 DOCN  M95A0910
 TI    Prevention of AIDS transmission through screening of the blood supply.
 DT    9510
 AU    Galel SA; Lifson JD; Engleman EG; Stanford Medical School Blood Center,
       Stanford University School; of Medicine, California 94305, USA.
 SO    Annu Rev Immunol. 1995;13:201-27. Unique Identifier : AIDSLINE
       MED/95336676
 AB    Shortly after the first cases of AIDS were reported in 1981, it became
       apparent that this disease was caused by a blood-borne infectious agent
       that could be transmitted by blood transfusion. Early reports documented
       a reduced ratio of CD4+ to CD8+ T cells not only in AIDS patients but
       also in likely carriers of the AIDS pathogen. On this basis, from July
       1983 to June 1985, our blood center utilized flow cytometry to test each
       donated unit for the ratio of CD4 to CD8 T cells; we did not transfuse
       blood from donors with CD4/CD8 < 0.85. Despite available data supporting
       the utility of this or other surrogate blood tests to screen blood
       donors, the vast majority of blood banks did not initiate blood donor
       testing for AIDS until 1985, following the discovery of HIV and
       development of commercial HIV antibody tests. Retrospective analysis
       indicates that donor screening with surrogate markers would have removed
       the majority of AIDS-contaminated units from the blood supply and
       prevented a substantial fraction of the estimated 10,000 cases of
       transfusion-transmitted AIDS in the United States. In this report, we
       review the events that led to our decision to initiate blood donor
       testing prior to the identification of HIV, the results of such testing,
       the consequences of the decision by most blood banks not to initiate
       such testing, the current status of the blood supply with respect to
       HIV, and steps that can be taken in the future to protect the blood
       supply from new pathogens.
 DE    Acquired Immunodeficiency Syndrome/HISTORY/*PREVENTION & CONTROL/
       *TRANSMISSION  AIDS Serodiagnosis/HISTORY  Blood
       Banks/HISTORY/LEGISLATION & JURISPRUD  Blood Donors  Blood
       Transfusion/*ADVERSE EFFECTS/HISTORY  California  Chagas
       Disease/TRANSMISSION  CD4-Positive T-Lymphocytes/IMMUNOLOGY  Female
       Hepatitis, Viral, Human/TRANSMISSION  History of Medicine, 20th Cent.
       Human  Licensure  Male  Retroviridae Infections/TRANSMISSION  Safety
       United States  HISTORICAL ARTICLE  JOURNAL ARTICLE  REVIEW  REVIEW,
       TUTORIAL

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