Screening blood products for HTLV-I: what is the best approach?

A recent concern for disease transmission by blood transfusion is T-lymphotropic virus type I (HTLV-I). This virus is endemic in Japan, the Caribbean basin, subsaharan Africa, and, to a lesser extent, the southeastern United States and parts of Central and South America. HTLV-I, which has been shown to be transmitted via transfusion, is associated with adult T-cell leukemia (ATL) and certain degenerative neurological disorders. Antibodies to HTLV-I, an indicator of exposure to the virus, have been demonstrated in 0.025% of healthy U.S. donors. This study, using the Decision Tree Model, presents an approach to a donor screening policy which should be cost-effective and yet ensure a safe blood supply.