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Should HIV testing be required?

HIV in blood transfusion -- question about testing?

  • I understand that because of the 'window' period in HIV antibodies being produced in a person that the testing done in blood donations are not 100% perfect for detecting HIV (or Hep C, etc). But in particular I am curious about HIV in blood transfusion. When someone is exposed, for example, they retest in six months to look for HIV antibodies. How come with testing of blood for transfusions the window period considered is only '22' days? Theoretically wouldn't it take six months for a blood donated to show up as HIV + for transfusion?? Does that make sense? What are some of the other tests they do on donated blood compared to someone being tested for HIV?

  • Answer:

    The window period is for a different type of test. The normal test, the antibody test, only looks for antibodies. The p24 antigen test is used for blood transfusions. Its a more expensive test, but is considered reliable after 3 weeks because it looks for proteins which show up before antibodies do. I was once diagnosed with HIV to later find out that I didnt have it (long story), so I learned alot about this stuff. The p24 test is very expensive for your average person (It was $900 last time I checked, without insurance) so individuals can get this test instead if they have the money and go to the places that use it, but most places just test for antibodies. Im sure the places that do blood transfusions get the p24 testing much cheaper than your average citizen since they have all the connections to the labs or own the labs themselves that test for this.

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NAT (nucleic acid testing) has reduced the window period on HIV to about 15 days. The test is so sensitive, that it can detect the virus RNA before an antibody can be detected. It isn't that it may take six months for the blood donated to show HIV, it may be the donor. The blood, when drawn from the donor, is only good for approximately 42 days. Other tests performed on donor blood included: ABO and Rh Antibodies to RBC antigens Syphilis Anti-Hepatitis C Hepatitis B (surface antigen and core antibody) Anti-HIV anti-HTLV-I/II Cholesterol Chagas Disease (anti T. cruzi) West Nile Virus by NAT Hepatitis C Virus/Human Immunodeficiency Virus by NAT The risk of contracting HIV thru blood donation is very small due to the utilization of NAT testing.

Terri C

The difference is one is looking for antibodies and the other test (used for blood donation screenings) is actually looking for the HIV virus. Donated blood is actually tested for both HIV antibodies and the HIV virus particle itself. The p24 test discussed earlier is actually an early version of testing that is not used much anymore. NAT (nucleic acid testing) is more preferential due to the increased sensitivity and greater ability to detect the antigens than the p24. See link below. The American Red Cross now uses the NAT testing model for not only HIV 1/2, but HCV and WNV (West Nile Virus) as well. Laboratory testing of donated blood prior to transfusion is intended to ensure that recipients receive the safest possible blood products. Such testing consists of determining the ABO blood group and Rh blood type of the donated unit, testing for red cell antibodies, and performing infectious disease screening for the following agents: HIV-1, HIV-2, human T-lymphotropic virus (HTLV)-I, HTLV-II, hepatitis C virus, hepatitis B virus, West Nile virus (WNV), and T. pallidum (syphilis). All infectious disease screening assays must be negative in order to release the blood unit or its components to hospitals for transfusion. HTH

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