Donor. In June 2008, a man in his forties donated whole blood at a blood center in Missouri (Figure 1). He was a repeat blood donor who reported no HIV risk factors on the routine eligibility screening questionnaire. He was not compensated for his blood donation. His whole blood donation was screened at a reference laboratory for HIV by enzyme immunoassay (EIA) (Genetic Systems HIV-1/HIV-2 Plus O EIA, Bio-Rad Laboratories, Redmond, Washington) and by nucleic acid amplification testing of minipools of plasma specimens (MP-NAT) from 16 donations (Procleix HIV-1 Nucleic Acid Test, Gen Probe, San Diego, California); both tests were negative. Components from this donation later were transfused into two recipients. No specimens from this donation were stored. In November 2008, the man donated blood again at the same blood center and again reported no risk factors on the routine eligibility screening questionnaire. At that time, his blood tested positive for HIV by EIA, MP-NAT, and indirect immunofluorescence assay (Fluorognost HIV-1 IFA, Sanochemia Corporation, Vienna, Austria). The man was placed on the list of donors who are indefinitely ineligible for future donation, all products from this donation were destroyed, and the man was notified by the blood center of his probable HIV infection. The Missouri Department of Health and Senior Services (MDHSS) was notified of this case on December 4, 2008. Because of the rare possibility that the donor might have been infected shortly before his June 2008 donation and donated blood that contained HIV at a concentration too low to be detected, an investigation was initiated to determine whether recipients of the June donation had been infected with HIV, consistent with regulatory requirements to investigate such events.
But the 2008 does indeed establish that it can indeed happen despite those 'infallible' tests you keep mentioning.
