In the summer of 1992, the U.S. Food and Drug Administration took a resoundingly uncontroversial step in the war on AIDS: It ordered all blood banks to test for a virus called HIV-2.
Even though the virus was vanishingly rare, no one seriously opposed the directive, not even the blood banks, which would have to pay for the testing. In fact, they publicly welcomed it. The subject of expense hardly came up.This was another virus that causes AIDS, after all, the most dreaded of all diseases. The blood banks inadvertently helped spread the AIDS epidemic in the early 1980s. Neither they nor their regulators wanted to make that mistake again.
"Cost was not a factor," recalled Dr. Charles Wallas, president of the American Association of Blood Banks.
So over the past year and a half, the blood banks have spent an estimated $30 million testing all donated blood for signs of HIV-2.
The result: Not a single infected donation has been found.
That's right. The country's blood banks have tested about 20 million units, and they have not turned up one drop of bad blood.
Unlike HIV-1, the primary AIDS virus that probably infects somewhat under 1 million Americans, HIV-2 is almost impossible to find in the United States. No one knows precisely how many people have it, but intensive searching has turned up less than 50 cases nationwide.
Some of those involved say HIV-2 testing was driven as much by fear of violating an apparently uncompromising public desire for blood safety as it was by any real medical need. Blood bankers themselves are of two minds about it.
"Why are we doing HIV-2 testing? We are erring on the side of caution," said Dr. James MacPherson, head of the Council of Community Blood Centers. His or-ga-ni-za-tion represents the nonprofit, non-Red Cross blood banks that collect about 35 percent of the nation's blood.
However, Dr. Paul Holland, medical director of the Sacramento Medical Foundation Blood Center in California, said the testing represents a hopeless attempt to make the blood supply 100 percent safe, no matter how slight the risk or high the cost.