Heterogeneous transfusion risk linked to variant Creutzfeldt-Jakob disease in a non-human primate model.

In cynomolgus macaques intravenously contaminated with v-CJD prions, peripheral prion replication in lymphoid organs is highly heterogeneous and largely tracks blood prion load detectable by amplification-based assays.

• Why it matters: Donor deferrals are being lifted despite uncertainty about silent infection and long incubation times, so iatrogenic risk estimates need better evidence than epidemiology alone.
• What they did: The study experimentally contaminated cynomolgus macaques with v-CJD prions and measured apparent peripheral prion replication in lymphoid organs, comparing patterns to amplification-detectable prion levels in blood.
• The result: Some primates developed incomplete prion phenotypes that can evade conventional diagnosis and transmit to immunodeficient mice, implying lymphoid prevalence studies may underestimate healthy v-CJD carriers and that risk assessments should incorporate experimental transmission data.

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