Acute HIV-1 Infection in Antigen/Antibody-negative Blood Donors in Dar es Salaam, Tanzania

Fourth generation human immunodeficiency virus (HIV) antigen (Ag)/antibody (Ab) enzyme-linked immunosorbent assay (ELISA) test used in the current screening of blood donors at the National Blood Transfusion Service centres has limited ability to detect HIV Ag/Ab during the first two weeks of the window period. The aim of this study was to determine the prevalence of acute HIV infection among HIV antigen/antibody negative blood donors. This was a cross-sectional blood donation based facility study conducted at Eastern Zone Blood Transfusion Services in Dar es Salaam from December 2009 to April 2010. Apparently healthy voluntary blood donors screened and accepted for blood donations were included. Blood donation screening questionnaires were used to obtain socio-demographic characteristics, history of past medical, sexual and blood transfusion of the study population. Blood specimen was collected for confirmation of the negative HIV Ag/Ab status by the Roche HIV-1 DNA polymerase chain reaction (PCR) test. A total of 552 blood donors with negative HIV Ag/Ab donated blood were included in the study. The overall mean age of blood donors was 27 years (18-54 years). About two thirds of the blood donors were in the age group of 18 - 27 years. Of 552 blood donors, 413 (75%) were males while 139 (25%) were females. Seventy two percent of blood donors were unmarried. About 71% were voluntary and the rest were replacement blood donors. The prevalence of acute HIV-1 infection by HIV-1 DNA PCR test was found to be 0.2%. It is concluded that many voluntary blood donors were found to be young, male and unmarried. Acute HIV-1 infection using HIV-1 DNA PCR test in the blood donors with negative HIV Ag/Ab donated blood was found to be very low. Further multi-centre study with larger sample size country wide is warranted to determine the magnitude of acute HIV infection in the blood donors with negative HIV Ag/Ab donated blood.