학술논문

Two human immunodeficiency virus Type 2 cases in US blood donors including serologic, molecular, and genomic characterization of an epidemiologically unusual case.
Document Type
Academic Journal
Author
Stramer SL; Scientific Affairs, the American Red Cross, Gaithersburg, Maryland.; Yu G; University of California at San Francisco, San Francisco, California.; Herron R; Southern California Blood Collection Region, American Red Cross, and.; Espinoza N; Donor and Client Support Center, American Red Cross, Pomona, California.; Foster GA; Scientific Affairs, the American Red Cross, Gaithersburg, Maryland.; Naccache SN; University of California at San Francisco, San Francisco, California.; Brodsky JP; Quality Analytics, Riverwoods, Illinois.; Ong E; Hologic, Inc., San Diego, California.; Linnen JM; Hologic, Inc., San Diego, California.; Dyer N; Roche Molecular Diagnostics, Pleasanton, California.; Styer LM; Wadsworth Center, New York State Department of Health, Albany, New York.; Parker MM; Wadsworth Center, New York State Department of Health, Albany, New York.; Chiu CY; University of California at San Francisco, San Francisco, California.
Source
Publisher: American Association Of Blood Banks Country of Publication: United States NLM ID: 0417360 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1537-2995 (Electronic) Linking ISSN: 00411132 NLM ISO Abbreviation: Transfusion Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Blood donation screening for human immunodeficiency virus Type 2 (HIV-2) has been in place in the United States since 1992. However, only three HIV-2 antibody-positive donors have been reported to date, all detected via HIV-1 cross-reactivity.
Study Design and Methods: Here we identify two additional HIV-2-positive donors by routine anti-HIV-1 and anti-HIV-2 screening, including a first-time male donor living in Georgia having recently immigrated to the United States from West Africa (from a 1998 donation) and a Taiwanese female repeat donor (nurse) living in California with no travel outside of Taiwan or apparent connections to West Africa (from a 2015 donation). Neither donor acknowledged any risk factors, and both remained asymptomatic through follow-up. The second donor was further investigated by serologic, molecular, and genomic assays because of her unusual demographics. She was documented to harbor HIV-2 RNA, albeit sporadically by HIV-2-specific nucleic acid tests (35%-100% of replicates) and at very low levels (<9.6 IU/mL). Metagenomic next-generation sequencing (mNGS) confirmed the identification of a Group B HIV-2 strain, with recovered reads covering 46.9% of the predicted genome.
Conclusions: The estimated frequency of an HIV-2-positive blood donor in the United States is one in 57 million donations. Due to the low frequency and low pathogenicity of HIV-2, public health and blood donation screening efforts must focus on HIV-1 detection and prevention. However, detection of HIV-2 infection in a donor with no apparent link to West Africa suggests that the United States must remain vigilant for HIV-2 virus infections. Ultradeep mNGS may be useful in the future for comprehensive identification of rare transfusion-transmissible agents.
(© 2016 AABB.)