Transfusion-associated transmission of human T-lymphotropic virus types I and II: experience of a regional blood center.

During a 22-month period, 78,000 blood donors were screened for human T-lymphotropic virus types I and II (HTLV-I/II) at Belle Bonfils Memorial Blood Center (Denver, Colorado). Positive donors and the living recipients of their previously donated blood components were evaluated for risk factors and symptoms related to HTLV-I infection, were screened by enzyme immunoassay, confirmed by Western blot for HTLV-I/II, and subsequently tested by polymerase chain reaction and peptide enzyme immunoassay to distinguish between HTLV-I and -II infection. Six seropositive blood donors (0.008%) were identified; four were typed as having HTLV-I infection and two as having HTLV-II. Of 18 living recipients of components from seropositive donors, none had risk factors for HTLV-I infection prior to transfusion and none had signs or symptoms of HTLV-I infection at follow-up. The mean time from transfusion to testing was 6.4 years. Seven recipients of HTLV-I-infected components were HTLV seropositive; all were typed as having HTLV-I. A possible case of posttransfusion HTLV-I-associated myelopathy was identified in one patient who died before complete evaluation. One possible case of transfusion-associated HTLV-II was identified. These data further support the continued screening of blood donors for HTLV-I/II.