Herpesvirus prevalence and viral load in healthy blood donors by quantitative real‐time polymerase chain reaction

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Abstract
BACKGROUND: After primary infection, human herpesviruses (HHVs) maintain long‐term latent persistence, often punctuated years later by sporadic episodes of symptomatic lytic activation. Also, blood‐borne herpesvirus from healthy persistently infected blood donors can lead to active primary infection of immunocompromised transfusion recipients. STUDY DESIGN AND METHODS: Utilizing a set of newly developed real‐time polymerase chain reaction assays for detection and quantification of all eight human herpesviruses, the prevalence and viral DNA load of white cell–enriched blood from 100 randomly selected blood donors from the southeast Texas region are reported. RESULTS: Herpes simplex viruses 1 and 2 (HSV‐1 and HSV‐2), varicella‐zoster virus (VZV), and HHV‐8 DNA were not detected in any donor sample. In contrast, Epstein‐Barr virus (EBV) (72%) and HHV‐7 (65%) were commonly detected, HHV‐6 (30%) was often detected (Type B only), and cytomegalovirus (CMV; 1%) was rarely detected. Median viral loads of positive samples (per milliliter of blood) ranged from 4278 for HHV‐6 to less than 46 for EBV. CONCLUSIONS: These results suggest that the potential for transfusion‐mediated transmission of herpesviruses from healthy adult blood donors is high for EBV and HHV‐7; moderately high for HHV‐6; uncommon for CMV; and rare for HSV‐1, HSV‐2, VZV, and HHV‐8. Perhaps the most remarkable finding in this study was the detection of a single donor sample with greater than 6.1 × 107 HHV‐6 Type B genome equivalents per mL blood. Given that this extraordinarily high level of HHV‐6 DNA was obtained from a healthy adult blood donor, this phenomenon is likely unrelated to active infection or immunodeficiency.