This work was supported by a grant from the National Heart, Lung and Blood Institute RC2HL101.
DONOR INFECTIOUS DISEASE TESTING
West Nile virus nucleic acid persistence in whole blood months after clearance in plasma: implication for transfusion and transplantation safety
Article first published online: 26 JUN 2014
© 2014 AABB
Volume 54, Issue 12, pages 3232–3241, December 2014
How to Cite
Lanteri, M. C., Lee, T.-H., Wen, L., Kaidarova, Z., Bravo, M. D., Kiely, N. E., Kamel, H. T., Tobler, L. H., Norris, P. J. and Busch, M. P. (2014), West Nile virus nucleic acid persistence in whole blood months after clearance in plasma: implication for transfusion and transplantation safety. Transfusion, 54: 3232–3241. doi: 10.1111/trf.12764
- Issue published online: 11 DEC 2014
- Article first published online: 26 JUN 2014
- Manuscript Revised: 15 MAY 2014
- Manuscript Accepted: 15 MAY 2014
- Manuscript Received: 31 MAR 2014
- National Heart, Lung and Blood Institute. Grant Number: RC2HL101
Previous reports of West Nile virus (WNV) RNA persistence in blood compartments have raised concerns around the remaining risk of WNV transfusion transmission. This study characterized the dynamics of WNV viremia in blood compartments in a longitudinal cohort of 54 WNV-infected blood donors.
Study Design and Methods
Blood samples were collected throughout the year after WNV RNA–positive blood donation (index) and characterized for WNV immunoglobulin (Ig)M and IgG antibodies and for WNV RNA by real-time reverse transcription–polymerase chain reaction. WNV viral loads were compared in plasma and whole blood samples and correlated with blood groups and clinical outcomes.
WNV RNA persisted in the red blood cell (RBC) compartment up to 3 months postindex in 42% of the donors. Donors with the highest WNV RNA levels in plasma at index maintained the highest WNV RNA levels in whole blood over the 3 months postindex. Blood group A donors maintained higher postindex WNV viral load in whole blood than blood group O individuals (p = 0.027). Despite a trend for WNV RNA to persist longer in whole blood from symptomatic subjects, no significant association was found between WNV RNA levels in whole blood and disease outcome.
This study confirmed that WNV RNA persists in the RBC fraction in whole blood and further suggested that the level of persistence in whole blood may be a reflection of initial viral burden in plasma. The association with blood groups suggests that WNV adherence to RBCs may be mediated by molecules overrepresented at the surface of blood group A RBCs.