A lucky outcome to a transfusion from an HIV-positive donor in the window-period

Despite remarkable improvements in the safety of blood transfusion during the last twenty years, a residual risk of transmitting viral infections through blood components persists. We report a case of a male repeat donor who donated whole blood at the Transfusion Centre of Lamezia Terme, Italy. Serologic screening was negative. Two weeks later he was admitted to the Infectious Disease Centre of the same hospital for fever and lymphadenopathy. HIV determination by NAT assay was positive. The donor revealed to have hidden from doctors that his male partner was HIV positive. Meanwhile, the blood was transfused to a woman during a caesarean birth but, luckily, HIV RNA and antibody assays performed on the recipient after two months were negative. A lookback determination of the possible day of infection allowed us to hypothesise that the transmission of HIV virus by transfusion was avoided just for one day. Normally, the use of selected, repeat blood donor is considered safe. The case reported here, on the contrary, shows that an accurate questionnaire and a careful interview must be done even in repeat and well-known donors. And that the possibility that a donor might deny his or her high-risk profile may exist.