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We have reviewed the literature pertaining to the use of blood collection systems for HIV-infected patients. We then prepared a set of guidelines for the optimal use of blood collection systems for HIV-infected patients.
There is increasing interest in the use of blood collection systems for the management of HIV-infected patients. Although the development of these new systems has significantly improved the safety of blood collection, the proper use of these new systems is essential to ensure an effective blood collection process and minimize the risk of occupational exposure to blood pathogens (4). A survey by the American Medical Technologists (AMT) found that more than 90% of clinical technologists were using a blood collection system that required the same set of needles for each patient. However, there is little systematic information describing the frequency with which these devices have been used, the reaction of HIV-infected patients to these devices, and whether these concerns have been adequately addressed by the manufacturers (5).
The need for a blood collection system that can be used without the risk of an occupational exposure in a high-risk patient population underscores the importance of the interpretation and application of published guidelines regarding optimal use of blood collection systems. Although most transfusion guidelines recommend the use of systems that prevent multiple needle-stick injuries, there are no published guidelines regarding the use of systems that do not require a change of needle for each patient.
The following is the most effective means of preventing disease transmission during a blood donation and receipt: Donate blood after at least 6 months of effective combination antiretroviral therapy Use aseptic technique when collecting blood from an HIV-infected donor Observe aseptic precautions when handling blood from an HIV-infected donor Perform at least two independent HIV-1 RNA PCR testing within 12 months of donation, without cross-contamination of the donor, or in cases where the donor has experienced a recent seroconversion: Perform HIV-1 RNA PCR testing of blood collected more than 2 weeks prior to donation and at the time of donation. Once a positive HIV-1 RNA PCR result is obtained, perform independent confirmatory HIV-1 RNA testing with an alternative system. If both the initial and independent confirmatory test are also positive, then the whole blood or plasma should be discarded.
The addition of new technologies in flow cytometry, such as multi-dimensional, time-resolved instrumentation, has enhanced the cell analysis capability, thereby allowing for a more comprehensive evaluation of cellular immunophenotyping, providing a multi-parameter approach to the characterization of cellular phenotype. Two-laser systems are now available, together with the ability to detect binding of cell-surface ligands to targeted receptors or proteins expressed on the cell surface. Furthermore, the addition of analytical tools, such as flow cytometric microspheres and flow cytometric beads, has made it possible to use multiple parameters for the analysis of cellular populations. 827ec27edc