The United Kingdom’s (UK) Health Protection Agency (HPA) released a report on the social and ethical implications of a possible blood test for variant Creutzfeldt-Jakob disease (vCJD), a rare, degenerative and fatal disorder. The report was based on the results of an HPA survey of 306 respondents, which included personnel from the National Health Service, clinicians and various health professionals, patient advocates, academic researchers, government officials and others. The report was conducted for the UK Department of Health.
There is no blood test that detects vCJD infection in people who are asymptomatic. However, tests are being developed to detect its presence in blood and plasma donors. A test could be used to screen donors, preventing vCJD-positive blood from entering the blood supply. When asked when they thought a vCJD test might be introduced, most respondents estimated between one and three years.
Presuming that a test will become available within a few years, the survey gleaned opinions from the medical community about potential concerns over vCJD testing. The report states that a “majority” thought that a test was necessary because the level of vCJD infectivity in the blood supply is currently unknown. However, multiple concerns were raised about the associated cost, sensitivity and specificity levels, the absence of prevalence data and the lack of a confirmatory test. Respondents were also concerned about how blood donors’ understanding of vCJD infection and testing might effect overall donations.
There have been four reported cases of vCJD transmission via blood transfusions in the UK, although no case has been associated with plasma-derived factor concentrates used to treat hemophilia.
“Whilst such a test could be valuable in helping to identify people who may be at risk, the report, published today by the HPA, highlights some of the ethical and practical questions we are facing, both in terms of supporting the people affected, and protecting the public,” said Caroline Flint, public health minister.
vCJD infectivity in humans is predominately linked to eating the contaminated meat from cattle infected by bovine spongiform encephalopathy. There have been no reported cases of vCJD transmission through the U.S. blood supply. Since 1999, the U.S. Food and Drug Administration has enforced donor deferral policies among all blood donations from people who lived or visited the UK for three months or longer between 1980 and 1996.
Read the report Opinion former attitudes towards the possible introduction of a vCJD test for blood donations.
Source: Medical Laboratory World, March 28, 2007