Several viruses are transmissible by blood transfusion. Lifeblood’s mandatory testing includes screening for a number of transfusion-transmissible viruses:
- human immunodeficiency virus (HIV) 1 and 2
- hepatitis B virus (HBV)
- hepatitis C virus (HCV)
Some red cell and platelet donations are also tested for antibodies to cytomegalovirus (CMV) in order to have a supply of CMV-seronegative cellular components available. Leucodepleted components are considered to provide a high level of safety in preventing transfusion transmission of CMV.
When required, additional donation testing is performed, including confirmatory testing, and screening for human T-cell lymphotropic virus (HTLV).
There are some viruses which, although transmitted by blood transfusions, are not routinely tested for in Australian donors, such as Dengue virus (Dengue Fever), West Nile virus, Chikungunya virus and Parvovirus B19 ("Slapped Cheek Syndrome" or Fifth disease).
The comprehensive medical and travel history which forms part of the donor assessment process excludes donors who have recently travelled to endemic areas or who engage in high-risk behaviour.
Usual causes
The primary cause of transfusion-transmitted viral infections is thought to be donations made by donors in the disease’s window period. This is the interval between the time of infection and the appearance of clinical symptoms or detectable disease markers, such as specific antibodies or viral nucleic acid sequences.
Investigation
Clinically assess patients for manifestations of specific viral infections.
Perform appropriate investigations and specific testing for viral markers.
What to do
Treat the specific diagnosis, if available, and notify Lifeblood.
