       Document 0258
 DOCN  M95B0258
 TI    How much would the safety of blood transfusion be improved by including
       p24 antigen in the battery of tests?
 DT    9511
 AU    Le Pont F; Costagliola D; Rouzioux C; Valleron AJ; Biomathematiques,
       Biostatistique, Bioinformatique et; Epidemiologie INSERM Unite, Faculte
       de Medicine; Saint-Antoine, Paris, France.
 SO    Transfusion. 1995 Jul;35(7):542-7. Unique Identifier : AIDSLINE
       MED/95357874
 AB    BACKGROUND: Because p24 antigen may be detectable during seroconversion,
       before antibodies, some of the infected blood undetected by antibody
       screening could be identified through antigen screening. STUDY DESIGN
       AND METHODS: The potential benefit of antigen screening was evaluated in
       a simulation model incorporating present knowledge of the time sequence
       from antigen exposure to antibody development during seroconversion and
       the incidence of seroconversion among repeat donors. The model was
       designed so that the results were consistent with the observed rate of
       antibody-positive blood donations and the CIs of surveys that did not
       find any antibody-negative/antigen-positive donated blood. RESULTS: In
       the United States in 1990, the number of expected, undetected,
       contaminated blood components was estimated at 68; of these 8 to 17
       could have been identified by antigen screening, depending on the
       hypothesis explored. (In 1992, 20 undetected, contaminated blood
       components were expected according to this model, of which 2 to 5 could
       have been identified by antigen screening.) In France, the comparable
       figures were 1 to 4 of 13 in 1990 and 1 to 2 of 7 in 1992. CONCLUSION:
       The projected benefit must be weighted against possible negative
       consequences, including 1) an increase in recently infected persons
       seeking p24 antigen screening at blood banks (assuming this test is not
       incorporated into screening in non-blood bank settings) and 2) the need
       for additional quality assurance procedures to avoid operational flaws
       associated with the increase in the donor screening test battery. In any
       case, the best way of increasing the safety of blood is improvement in
       the selection of donors, which can diminish the residual risk of
       transmission of any viruses.
 DE    Biological Markers  Blood Banks/ECONOMICS/STANDARDS  Blood
       Transfusion/ADVERSE EFFECTS/*ECONOMICS  Computer Simulation  Costs and
       Cost Analysis  Human  HIV Core Protein p24/*ANALYSIS  HIV
       Infections/*PREVENTION & CONTROL  Quality Control  Support, Non-U.S.
       Gov't  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

