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In 1993, a Committee to Study HIV Transmission through Blood and Blood Products was established by the US Institute of Medicine. The study was published in 1995 and concluded that it would have been "reasonable to require" donated blood to be screened for the anti-HBc antibody and for male donors to be asked about sexual activity with other men in January 1983.

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Dr John Barbara stated in his witness statement that he did not agree entirely with Dr Craske's view regarding anti-HBc screening. Dr Barbara felt that anti-HBc screening would help to detect the transmission of AIDS. He said: "testing for anti-HBc would give some evidence of a past hepatitis B infection. Anti-HBc positivity might reflect a shared route of infection by HBV or HIV."

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The minutes of the meeting of regional transfusion directors on 18 May 1983 did not record the consideration of whether anti-HBc screening could help to detect the transmission of AIDS.

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The minutes of the CBLA Central Committee's first meeting on 21 June 1983 recorded a discussion of ways of dealing with the problems of AIDS for the blood supply, and that not enough was known about AIDS to enable any decision to be made. It is unclear whether any of the discussion focused on surrogate testing.

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At a meeting of the CBLA Central Committee on 27 November 1983, the proportion of donations which might be excluded by a positive test was indicated by the percentage of samples obtained in Bristol which tested positive, which was 0.75% (75
cases out of 10,000 tests). However, it emerged that 48 out of these 75 were prisoners, so it was decided that another 10,000 donations excluding those from prisoners would be tested.

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The minutes of the meeting of the CBLA Central Committee on 7 November 1983 recorded that the Committee "welcomed the action taken with respect to the investigation of the use of surrogate tests".

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Dr Brian McClelland prepared a discussion paper on "Non-specific markers for persons at risk of transmitting AIDS" in response to studies of anti-HBc in the donor population of some RTCs and discussion as to the further action that should be taken in relation to anti-HBc positive donors.

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A letter from Dr Brian McClelland to Dr Cash regarding a study on non-specific markers for high-risk donors noted that the CBLA wanted a proposal at the end of February 1984 and that Dr Tim Wallington was deputed to do this.

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An outline proposal for a donor screening study to be initially conducted in Edgware and Bristol was prepared by Dr Tim Wallington and presented at a CBLA meeting. It evidenced an early hypothesis that AIDS could be transmitted through blood and proposed 50,000 donors across the two centres would be screened to see the correlation between "at risk" of AIDS groups and anti-HBc positive results.

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The final version of a proposal titled "The Acquired Immunodeficiency Syndrome (AIDS): Can laboratory screening tests identify blood donors at high risk of transmitting AIDS?" was presented by Dr Tim Wallington to the CBLA meeting on 28 February 1984. It was written in the form of a grant proposal to the MRC.

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Dr Smithies of the DHSS wrote to Dr Sibellas following the CBLA meeting on 28 February 1984 and explained that: "when asked I said that the Department [of Health] would be very happy to look at the proposal but similar constraints to those at the MRC (i.e funds) would apply."

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A note of a CBLA Central Committee for Research and Development meeting on 28 February 1984 taken by Dr Albert Bell, of the Scottish Home and Health Department, recorded his sense that there was not a great enthusiasm for this particular study, but that steps had to be taken to identify potential transmitters of AIDS and no one could produce a better study protocol.

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Dr T Wallington wrote to Dr Gunson explaining that the study to be proposed on 28 February 1984 was smaller than originally discussed, but that he hoped they would be able to pursue them and that he was sure it would provide answers if they did.

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At a meeting of the NIBSC Infectious Hazards of Blood Products, it was noted that the anti-hepatitis B core antibody was positive in more than 90% of AIDS cases in the US. However, there was no agreement that testing for the Hepatitis B core antibody should be included in routine screening of all donors.

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At a meeting of the MRC's Working Party on AIDS, Dr Wallington's application for funding was not discussed, but considered how such projects should be handled, and it decided that applications should continue to be submitted in the normal way to the MRC and/or DHSS.

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Dr Harold Gunson wrote to the DCMO Dr Edmund Harris and noted that it was very important that Dr Wallington's proposed study be put into operation as he feared they would otherwise be forced into the cost of anti-HBc testing because of developments in the US.

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Dr Harold Gunson wrote to members of the Central Research Committee AIDS Working Party to circulate an American Association of Blood Banks' newsletter discussing anti-HBc testing, and noted that UK efforts in this direction would be 'timely'.

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At a meeting of the CBLA, Dr Gunson suggested that the application to the MRC made by Dr Wallington for funding was now being modified due to proposed screening tests for HTLV-3/HIV.

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The MRC Working Party on AIDS met where it was recorded that the number of cases of AIDS in the UK was continuing to rise sharply.

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Within Drs Barbara and Tedder's Viral Infections Transmitted by Blood and Its Products Clinic report it was described how it was not known whether this would be a suitable or effective screen for donors who constituted a high risk of transmission of AIDS.

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