?We are not homophobic?

I have read with much interest your articles on blood donations of the 18th of May 2007 (16158) by Pauline Etienne and the editors? comments in ?De quoi se faire du mauvais sang? of Sunday 19th May 2007. I would very much appreciate if you could kindly publish my comments related to these articles.

I am a Mauritian working in the UK, as a Clinical Microbiologist and a Scientist working on sexually transmitted diseases and blood-borne viruses. I am quite surprised that Danielle, who is gay, felt offended when her blood was refused by the collection staff of the Blood Transfusion Service (BTS).

I feel sorry for her, but nonetheless, there are some international guidelines that have to be followed and I do not think for any moment that the BTS is homophobic, but acted responsibly to protect the health of blood recipients.

Before we look at international guidelines, I would like to go through the process from the time blood is collected until it reaches patients in the wards.

Once blood is collected, it goes through very stringent processes in Mauritius and the standards are comparable to the UK. First the blood samples are ABO and Rhesus grouped, the serum samples from the collected blood bags are tested for a battery of infections including HIV and Syphilis.

The blood collected, depending on needs, is further processed to provide different components that may be required depending on patients? need. The components can be Fresh Frozen Plasma (FFP), Platelets, Factor VIII, Packed Cells, or Whole Blood. Hence one blood bag can be transfused to at least four patients.

Now suppose for a moment someone is infected with HIV, antibodies to the virus are produced between 3- 8 weeks after infection(http://data.unaids.org/Publications/IRC-pub04/testmtu_en.pdf).

Hence detection of the virus would only be possible after 21 days.

However, the BTS uses a better test. This test on top of detecting antibodies also detects a viral antigen called antigen p24. This test will detect positive samples after 16 days of infection. This still leaves a window period of 16 days when the test will be negative. There is no better test on the market at the moment. During this time blood that are positive with HIV will be missed.

Now suppose that your blood donor is in the high risk category (Gay, Intravenous Drug Users etc.) and could have contracted HIV and was not aware of it and gave blood. This contaminated blood may in turn contaminate a minimum of four patients directly. These four patients can in turn contaminate their partners. Hence from one contaminated blood donor we can end up with several innocent individuals who will end up contracting HIV.

If you visit the website for transfusion guidelines in UK

http://www.transfusionguidelines.org.uk/index.asp?

Publication=DL&Section=12&pageid=391

There is a very interesting reference from Vox Sanguinis, an important scientific journal in the field of transfusion; which I would like to quote ?Abolishing the rule for gay men would increase the risk of HIV infected donations entering the blood supply in England by about five times, and changing the rule to allow gay men to donate one year after they last had sex with another man would increase the risk by 60 %, (Vox Sanguinis, 2003)?.

This may be different for gay females, but we have to draw the line and decide on a policy that is fair and does not bias towards one specific sex.

Finally, I would like to ask a moral question to those gay people or HIV sufferers:

Would you like to see more people contaminated with HIV by trying to change the policy of the Blood Transfusion Service by insisting that the BTS took your blood?

Or you would rather help to control the progression of HIV?

I am glad to say that we are not homophobic. The health of the nation is our priority, whether you are gay or straight! I am sure the leaders of PILS and Arc en Ciel would agree with me!

I rest my case!

SANJIV