1. Infectivity in chimpanzees (Pan troglodytes) of plasma collected before HCV RNA detectability by FDA-licensed assays: implications for transfusion safety and HCV infection outcomes.
- Author
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Busch MP, Murthy KK, Kleinman SH, Hirschkorn DF, Herring BL, Delwart EL, Racanelli V, Yoon JC, Rehermann B, and Alter HJ
- Subjects
- Animals, Blood Safety standards, Blood Specimen Collection, Blood-Borne Pathogens isolation & purification, Female, Hepacivirus isolation & purification, Hepatitis C diagnosis, Hepatitis C virology, Licensure, Limit of Detection, Pan troglodytes, RNA, Viral analysis, RNA, Viral isolation & purification, Serologic Tests methods, United States, United States Food and Drug Administration legislation & jurisprudence, Blood Donors legislation & jurisprudence, Blood Safety methods, Hepacivirus genetics, Hepatitis C blood, Hepatitis C transmission, RNA, Viral blood
- Abstract
Serial plasma aliquots (50 mL) obtained from 10 commercial donors who converted from hepatitis C virus (HCV) RNA negative to positive were transfused into 2 chimpanzees to assess infectivity during early HCV infection. Plasma, obtained 4 days before HCV RNA detectability by licensed assays, transmitted HCV infection to chimpanzee X355. The infectious PCR-negative plasma was subsequently shown to be positive in 2 of 23 replicates using a sensitive transcription-mediated amplification (TMA) assay, and estimated to contain 1.2 HCV RNA copies/mL (60 copies/50 mL transfused). Plasma units obtained up to 8 weeks earlier were not infectious in a second susceptible chimp, even when from donors with low-level, intermittent HCV RNA detection. Chimp x355 developed acute viremia with subsequent seroconversion, but cleared both virus and Ab in 17 weeks. When rechallenged 38 months later with 6000 RNA copies/mL from the same donor, X355 was transiently reinfected and again rapidly lost all HCV markers. We conclude that: (1) transfusions can transmit HCV infection before RNA detection, but the interval of test-negative infectivity is very brief; (2) early "blips" of HCV RNA appear noninfectious and can be ignored when calculating residual transfusion risk; and (3) markers of HCV infection can be lost rapidly after exposure to low-dose inocula.
- Published
- 2012
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