Infectivity in chimpanzees (Pan troglodytes) of plasma collected before HCV RNA detectability by FDA-licensed assays: implications for transfusion safety and HCV infection outcomes

Blood. 2012 Jun 28;119(26):6326-34. doi: 10.1182/blood-2011-12-393637. Epub 2012 Apr 12.

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.

Publication types

  • Evaluation Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Animals
  • Blood Donors* / legislation & jurisprudence
  • Blood Safety / methods*
  • Blood Safety / standards
  • Blood Specimen Collection
  • Blood-Borne Pathogens / isolation & purification
  • Female
  • Hepacivirus / genetics*
  • Hepacivirus / isolation & purification
  • Hepatitis C / blood*
  • Hepatitis C / diagnosis
  • Hepatitis C / transmission*
  • Hepatitis C / virology
  • Licensure
  • Limit of Detection
  • Pan troglodytes
  • RNA, Viral / analysis
  • RNA, Viral / blood*
  • RNA, Viral / isolation & purification
  • Serologic Tests / methods
  • United States
  • United States Food and Drug Administration / legislation & jurisprudence

Substances

  • RNA, Viral