I donated blood again on September 19. On the 30th, the Red Cross office in Charlotte sent me a letter that said, “When we tested your blood, we obtained some inconclusive results. These results indicate that you may be infected with human immunodeficiency virus (HIV), the virus that causes AIDS. In almost all cases, individuals with these inconclusive results are found later to not have the infection at all, but rarely individuals are found to be in the early stages of infection.” The letter went on to urge me to see my physician about this and have further testing done.
Me, infected with HIV? It didn’t seem possible. I’ve never engaged in any risky sexual activity, never used intravenous drugs, never received a blood transfusion. I’ve had no contact with other people’s blood or accidental needle sticks. What other methods of infection are there? I couldn’t think of any. It had to be a mistake.
I won’t keep you in suspense. I visited my doctor on October 7 to have blood drawn for HIV testing, and I got the results today. All the tests were negative. I’m not infected. Which is what I was expecting, but this is not the sort of thing about which you want to have any doubt.
So I can breathe a sigh of relief and forget all about this, right? Yes, except for one thing. The Red Cross’s letter included this statement: “For the safety of blood recipients, the American Red Cross cannot accept blood from donors who have inconclusive test results for any infectious disease. This means that you are no longer eligible to donate blood.” The Red Cross has no choice about this. They are bound by the FDA’s policies concerning the blood supply, which are very clear: “Although the need for donors is great, it is in the best interests of the recipients of such donations to err on the side of safety. Unfortunately, once an indeterminate or inconclusive result is obtained, the donor should be indefinitely deferred.”
I’ve been through this before. In 1993, one of my blood donations showed elevated levels of alanine aminotransferase (ALT). This liver enzyme is an indicator for possible hepatitis C virus (HCV) infection. At the time it was the best test available to the Red Cross for screening out HCV-infected blood, so they sent me a letter informing me of the test results and telling me that I couldn’t donate anymore.
But elevated ALT levels can be caused by a number of things other than HCV, including obesity (which was a plausible explanation in my case, back in 1993). This led the Red Cross to indefinitely defer a lot of donors who didn’t have HCV, which made chronic blood shortages even worse. As more accurate screening methods became available, the ALT test’s value declined. In January 1995, the National Institutes of Health recommended that the use of ALT for HCV screening be abandoned. In August, the FDA concurred. The Red Cross revised its donor policies, and I received letter telling me that I was welcome to resume donating.
So “indefinitely” doesn’t necessarily mean forever. In a couple of years, I may get another letter from the Red Cross begging me to come back. If not, I suppose that after 24 years and over five gallons donated, I’m entitled to retire. But I’ll miss the free cookies and Diet Coke.