Blood donors

The transmission of blood-borne infections such as HIV through transfusions could have extremely serious consequences for patients. The UK Blood Services therefore have a number of measures in place to ensure these risks are kept to a minimum.

People who may be at a higher risk of having an infection are asked not to make blood donations. Amongst others, this applies to men who have sex with men, those who have injected drugs, those who have sold sex, and those who have been sexually active in high-prevalence countries, or whose partner has been sexually active in high-prevalence countries.

The last two restrictions apply to behaviour in the last twelve months, and many believe that the restriction on men who have had sex with men should work in a similar way, rather than the current lifetime ban. These exclusions are recommended to the government by the Advisory Committee on the Safety of Blood, Tissues and Organs (SABTO) and are regularly reviewed to ensure they reflect current evidence.

In terms of testing, all blood donations in the UK have been screened for HIV antibodies since October 1985. Later, fourth-generation tests were introduced (from 2001, except in Northern Ireland) as well as pooled RNA testing (in some regions from 2002, and in all parts of the UK from 2007).¹

If a sample from a donor is reactive ('positive') in either of the initial tests, the donation will be quarantined, so that it cannot be issued to a hospital. If the reaction in the test occurs repeatedly on retest (in duplicate), the donation is discarded. All samples which are repeat reactive in either of the tests are referred to a reference laboratory for confirmatory testing.

Blood donors are not contacted individually to inform them of negative test results.

If a donor has a confirmed positive result for HIV, the standard procedure is to send a letter inviting the donor to a face-to-face meeting at a blood centre to discuss the test results and provide a further blood sample. At the meeting, the donor would be informed of the infection, asked to stop donating blood, given appropriate advice and information, and referred direct to appropriate healthcare services.

There is no set timescale for this to happen, although it would normally be within seven to 21 days following a donation. Care is taken to ensure that donors receive letters sufficiently early in the week, so that they are able to make contact and confirm their appointment. A meeting in person would always be the preferred way to inform a donor of a positive HIV test result. Other options such as giving results by telephone, or via the GP, with appropriate immediate referral to local services would only be considered if a meeting was not possible, and results would never be sent by e-mail or letter.

Blood centres in the UK (excluding Scotland) and Republic of Ireland pass anonymised information about infected blood donors to the Health Protection Agency. This information includes the characteristics of the infected donor, details of their donating history and any behaviour that could be associated with the donor's infection. This information is used in calculating risk assessments and in assessing the efficacy of donor selection guidelines.