HIV screening of the blood supply in developed and developing countries

In most developed countries of the world, the risk of human immunodeficiency virus (HIV) transmission by blood and blood products is extraordinarily small. This level of safety has been accomplished by successive refinements in donor screening and testing procedures. Various inactivation techniques have been successfully used in the manufacture of plasma derivates and are being developed to inactivate bacterial and viral contaminants in cellular components. The most recent and powerful tool in this multi-layer safety net has been the introduction of nucleic acid techniques to capture donations from individuals in the very early stages of infection before a detectable serologic response has developed. This technique, while extremely costly, holds promise for other emerging agents that may pose a risk to the blood supply. In sharp contrast, in resource-poor countries of the world, blood transfusion remains a major avenue of transmission of HIV. Not only is much of the blood supply simply not tested, but there is a lack of infrastructure to support and equip blood banks, train personnel, recruit safe donors, promulgate the judicious and appropriate use of blood, and prevent anemia. A global collaborative effort is needed to ensure that there is a reliable and safe blood supply throughout the world.