Kitchen, Alan David; (1992) The significance of human cytomegalovirus infection in healthy blood donors. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Human cytomegalovirus (HCMV) infection has been studied in blood donors. The subsequent establishment of latency by the virus is a significant factor in blood transfusion practice as the latent virus may be transmitted by transfusion to susceptible patients with serious consequences. The current prevalence of HCMV-IgG in the donor population was found to be 47% and related to donor age and sex; increasing with age and significantly higher in females (p < 0.001). The prevalence of HCMV-IgM and -IgA in the donor population was determined in an attempt to identify recently infected donors, purported to give rise to an increased incidence of HCMV transmission. They were detected in 0 09% and 1-5% of donors respectively; no other indications of recent infection were detected. The immune response to HCMV was found to be stable with respect to Ab titre and immunoblotting profiles. The current seroconversion rate of HCMV-Ab negative donors was found to be approximately half of that expected. To identify acutely infected donors and to confirm the presumed sites of latency, studies were performed using conventional and molecular techniques to detect either infectious virus or viral nucleic acid in donated blood or saliva and urine samples obtained from donors. HCMV nucleic acid was not detected in serum or leucocytes by dot-blot hybridisation, although HCMV DNA and IE RNA were demonstrated in leucocytes using the PCR technique. Urine from one seropositive donor was found to contain detectable HCMV by cell culture and PCR. No saliva samples were found to contain HCMV. Although HCMV can be detected in healthy donors using molecular techniques, HCMV-Ab screening remains the most appropriate method for determining those donations likely to transmit HCMV.

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