FEARS ABOUT THE BLOOD SUPPLY
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(MONEY Magazine) – The report in October's Money Newsline, ''How to Avoid the New Threat to the Blood Supply,'' will unnecessarily alarm some of your readers. No one in government, in science or in medicine has a single shred of evidence to suggest that idiopathic CD4 lymphocytopenia (ICL), which you refer to as an AIDS-like disease, is in any way currently linked to a virus, let alone one transmitted by blood transfusion. The only links to AIDS are the rare opportunistic infections that are also common to AIDS patients. In no other way do AIDS and ICL bear a resemblance. Nevertheless, the Centers for Disease Control as well as the blood banking organizations are truly sensitized to the need to continue following this latest concern and are doing so. At present, unlike HIV, there is no evidence that any of the 37 known ICL cases are related to high-risk behaviors or blood transfusion. The cases, unlike AIDS, are not clustered in any location, within any socioeconomic grouping, nor is there any sign that any of the afflicted individuals have transmitted the syndrome to anyone else. Also, unlike AIDS, most of these patients have recovered, although their CD4+ T4-cell counts remain low. In addition, there is evidence that 0.25% of the population surveyed have normally reduced CD4+ cell counts but are without symptoms of any kind. Contrary to Dr. Edgar Engleman's remarks in your report, there is no available surrogate test that could be run routinely for the entire blood supply at this time. There are only a few instruments available to perform routine T4/T8 ratios (a possible surrogate test that can be an early measure of CD4+ T4 cell deficiency). Perhaps when simpler devices become available that would permit mass screening, they will be adopted if data being collected by the CDC warrant it. At the moment, their availability and the need remain in question. Finally, we encourage those who are able to donate blood for their own use. Many patients, however, are unable to be autologous blood donors. With the many safeguards now in place, the danger of infectious disease transmission from blood transfusion ranks very low on the list of hazards related to surgical intervention. No patient should avoid medical or surgical treatment because of an irrational fear of AIDS or ICL transmission. Joel M. Solomon, Ph.D. Executive director, American Association of Blood Banks Bethesda, Md.