Brian Custer, PhD, MPH of Vitalant Research Institute said antiretrovirals could theoretically mask the presence of HIV in people who donate blood.
The U.S. Food and Drug Administration already bans HIV-positive people from donating blood. All blood is screened for HIV before it is allowed entry into the U.S. blood supply.
Custer and his colleagues recently published findings in the journal Blood. They conducted blind testing for antiretrovirals in blood donation samples taken from people identified as HIV-positive via blood donation screening, as well as from donors who tested HIV-negative. The researchers also analyzed samples from blood donations from 18 to 45 year old HIV-negative men, testing for the presence of tenofovir disoproxil fumarate (TDF) and emtricitabine, the two components of Truvada, which is the first drug approved for the prevention of HIV infection (PrEP).
The researchers also looked at data regarding self-reported PrEP use around the time blood is given among men who have sex with men.
No antiretrovirals were found in the 300 samples of HIV-negative people. However, 46 of the samples, or 15 percent of the samples, showed evidence of antiretrovirals. 94 percent of those samples were from first time blood donors and 74 percent were from men.
Among the HIV-positive donors, donors between the ages of 45 and 54 and first-time donors were more likely to have antiretrovirals in their blood than younger donors or repeat donors.
Nine (0.6 percent) out of 1,494 samples from first-time male donors tested positive for the two components of Truvada.
27 (4.8 percent) of the 591 men who have sex with men reported using PrEP around the time of blood donation.
The researchers expressed concern that ARVs in the bloodstream of blood donors could mask the presence of HIV in their blood to the point where HIV testing used to screen the U.S. blood supply could fail to detect the virus. It is theoretically possible such a blood donation could lead to HIV transmission to its recipient, but there is no direct evidence HIV transmission has ever occurred in this fashion.
“Persons who are HIV positive and taking [ARV treatment] and persons taking PrEP to prevent HIV infection are donating blood,” the study’s authors concluded. “Both situations could lead to increased risk of HIV transfusion transmission if blood screening assays are unable to detect HIV in donations from infected donors.”