HIV - ELISA negativo com NAT positivo: Uma realidade em hemoterapia

Abstract

Transfusion safety is a major concern all over the world with new technologies being developed to increase the protection of patients. Developed countries and some Brazilian private blood banks have already implemented tests to detect HIV and HCV nucleic acid material (NAT). Despite the increase in transfusion safety promoted by these tests, financers and administrators are resistant to pay for its widespread implementation. We report here on the detection of a window period for HIV identified by the NAT test: A donor candidate showed up at the blood bank in August 2007 and after a clinical interview and hematological screening he was considered suitable for donation and did not choose self-exclusion. All serologic tests were negative except NAT for HIV. Twelve days after donating, the donor returned to draw another blood sample, which was positive for NAT for HIV and combined ELISA Ag/Ab. On this occasion, he reported that he was being treated for pneumonia and had had homosexual relationships within the 4 weeks preceding blood donation. One week after this second sample, a third one was collected, which resulted in being positive for NAT, ELISA Ag/Ab and ELISA HIV 1/2. This report illustrates the importance of performing the most sensitive serologic screening tests possible in blood donors, and reiterates the responsibility of physicians, hospitals and financers. It is important to emphasize the obligation of using every available resource in order to increase transfusion safety as neglect is an ethical infraction with legal responsibilities.