Detection of Disease: Possibilities and Limitations

  • Joost Th. M. de Wolf
Part of the Developments in Hematology and Immunology book series (DIHI, volume 37)


Much has and can be done to make blood transfusion as safe as possible. These include preventive measures beginning with donor education, screening, selection and deferral procedures, post-donation product quarantine and donor tracing when transmission of an infectious agent occurred. In addition we can test the blood for the presence of infectious agents. We can also use inactivation methods like solvent and detergent, or replace the use of blood by alternatives such as recombinant products, for instance clotting factor VIII or IX or the use of blood substitutes. In this paper we will further focus on the screening of blood for infectious agents. At the end it will be clear that blood safety is not equal to the detection of an infectious agent. In order to come as close as possible to the detection of disease the decision to screen for infectious agents should be based on certain principles which will be discussed later.


Human Immunodeficiency Virus Human Immunodeficiency Virus Infection Infectious Agent Nucleic Acid Amplification Test Chicken Anemia Virus 
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  1. 1.
    Busch MP, Young MJ, Samson SM, Mosley JW, Ward JW, Perkins HA. Risk of human immunodeficiency virus (HIV) transmission by blood transfusion before the implementation of HIV-1 antibody screening. The Transfusion Safety Study Group. Transfusion 1991; 31: 4–11PubMedCrossRefGoogle Scholar
  2. 2.
    Kenny-Walsh E, the Irish hepatology research group. Clinical outcomes after hepatitis C infection from contaminated anti-D immune globulin. N Engl J M 1999; 340: 1228–33Google Scholar
  3. 3.
    Roudot-Thoraval F, Bastie A, Pawlotsky JM, Dhumeaux D, study group for the prevalence and the epidemiology of hepatitis C virus. Epidemiological factors affecting the severity of hepatitis C virus related liver-disease: a french survey of 6664 patients. Hepatology 1997; 26: 485–90Google Scholar
  4. 4.
    Nishizawa T, Okamoto H, Konishi K, Yoshizawa H, Miyakawa Y, Mayumi M. A novel DNA virus (TTV) associated with elevated transaminase levels in posttransfusion hepatitis of unknown etiology. Biochem Biophys Res Comm 1997; 241: 92–97Google Scholar
  5. 5.
    Handa A, Dickstein B, Young NS, Brown KE. Prevalence of the newly described human circovirus, TTV, in United States blood donors. Transfusion 2000; 40: 245–52PubMedCrossRefGoogle Scholar
  6. 6.
    Biagini P, Gallian P, Touinssi M, et al. High prevalence of TI’ virus infection in French blood donors revealed by the use of three PCR systems. Transfusion 2000; 40: 590–96PubMedCrossRefGoogle Scholar
  7. 7.
    Wang JT, Lee CZ, Kao JH, Sheu JC, Wang TH, Chen DS. Incidence and clinical presentation of posttransfusion TT virus infection in prospectively followed transfusion recipients: emphasis on its relevance to hepatitis. Transfusion 2000; 40: 596–602PubMedCrossRefGoogle Scholar
  8. 8.
    Kleinman S Hepatitis G virus biology, epidemiology, and clinical manifestations: implications for blood safety. Transf Med Rev 2001;15:201–13Google Scholar
  9. 9.
    Prince AM, Lee D-H, Brotman B. Infectivity of blood from per-positive, HBsAg-negative, anti-HBs-positive cases of resolved hepatitis B infection. Transfusion 2001; 41: 329–32PubMedCrossRefGoogle Scholar
  10. 10.
    Ling AE, Robbins KE, Brown TM, et al. Failure of routine HIV-1 tests in a case involving transmission with seroconversion blood components during the infectious window period. JAMA 2000; 284: 210–14PubMedCrossRefGoogle Scholar
  11. 11.
    Klein HG. Will blood transfusion ever be safe enough? JAMA 2000; 284: 238–40PubMedCrossRefGoogle Scholar
  12. 12.
    Busch MP and Dodd RY. NAT and blood safety: what is the paradigm? Transfusion 2000; 40: 1157–60PubMedCrossRefGoogle Scholar
  13. 13.
    Williamson L, Cohen H, Love E, Jones H, Todd A, Soldan K. The serious hazards of transfusion (SHOT) initiative: the UK approach to haemovìgilance. Vox Sang 2000; 78 (Suppl 2): 291–95.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2002

Authors and Affiliations

  • Joost Th. M. de Wolf
    • 1
  1. 1.Dept of HaematologyUniversity HospitalGroningenNL

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