Factor VIII levels in patients with mild or moderate hemophilia A. MASAC also stated that it was important to screen and exclude all high-risk donors from the blood and plasma supply for the production of blood products used for treatment of hemophilia. The NHF directed their recommendations to treating physicians, regional and community blood collection centers, and plasma fractionators; in some instances, the NHF also told their chapters to distribute the information to the chapter members.

Position of the Plasma Fractionation Industry

On January 28, 1983, the American Blood Resources Association (ABRA), which represents the plasma industry, issued recommendations about donor screening and deferral to reduce the risk of AIDS. The recommendations focused on donor education, donor screening, and surrogate laboratory testing. The ABRA recommended issuing a brochure that would describe AIDS, tell how individuals in high-risk groups could reduce their risk of exposure, and discourage high-risk persons from donating. The ABRA also recommended that prospective donors, prior to donating, be required to read the information about AIDS and indicate that they were not members of a high-risk group. Individuals who identified themselves as members of high-risk groups or were unwilling to reply would be excluded from donating plasma (donor deferral). The ABRA recommended against large-scale surrogate testing of donated blood until ABRA had evaluated its feasibility.

On December 17, 1982, prior to ABRA's recommendations, Alpha Therapeutics, one of the four commercial manufacturers of AHF concentrate, had begun excluding all plasma donors who identified themselves as having been in Haiti, having used IV drugs, or if male, having had sexual contact with another man. Alpha had notified all its affiliates that this policy was effective immediately and that unscreened plasma should no longer be sent to Alpha. By the early part of 1983, each of the companies had in place donor education and screening programs requesting members of high-risk groups to identify themselves and refrain from donating plasma (FDA, BPAC, 1983b).

Federal Recommendations on the Prevention of AIDS

In a March 4, 1983 report, the PHS promulgated its first official recommendations on the prevention of AIDS. The recommendations stated that the evidence suggested the disease was a severe disorder of immune regulation caused by a transmissible agent (CDC, MMWR, March 4, 1983). As evidence, the report indicated that the transmission routes of AIDS paralleled that of hepatitis B and that blood or blood products appeared to be responsible for



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