A POTENTIAL BLOOD DONOR. J. Kimberly 1 , R. Watkins 2 ; 1 Wake Forest University Baptist Medical Center, Winston-Salem, NC; 2 Wake Forest University, Winston-Salem, NC (Tracking ID #76222) LEARNING OBJECTIVES: 1) Be able to counsel patients with evidence of infection with HTLV-I and 2) appreciate associated diseases. CASE INFORMATION: A 43 year old African American female with a history of hypertension, diabetes, and treated syphillis presents to clinic reporting that she fears she may have contracted HIV disease. She recently donated blood and subsequently received a letter stating she could no longer donate blood``because of an infection like AIDS.'' The patient presented the letter which notified her of the presence of HTLV-I/II antibodies with Western Blot confirming HTLV-I infection. ELISA for HIV 1 and 2 was performed and was negative. The patient was initially fearful and had many questions regarding HTLV-I infection: How did she get infected and was it sexually transmissible or contagious via other routes? Would she develop immunosuppression similar to that seen with HIV disease? Were there any other possible adverse effects on her health? IMPLICATIONS/DISCUSSION: HTLV-I is a retrovirus endemic in parts of Japan with other clusters of high prevalence including the southeastern US. The virus is transmitted by three known routes: 1) from mother to child, especially through breast feeding, 2) through sexual activity, and 3) through blood, either from contaminated needles or transfusion. In areas where HTLV-I is endemic, many inflammatory and autoimmune diseases have been attributed to the virus though causation has only been shown for two diseases. HTLV-I is clearly linked to adult T-cell leukemia/lymphoma (ATL), classically an aggressive, usually deadly, hematogenous malignancy characterized by rapid progression of skin lesions, pneumonitis, hypercalcemia, and lymphocytosis. The second disease with a clear association with HTLV-I infection is tropic spastic parapesis or HTLV-I-associated myelopathy (HAM) which, unlike ATL, is characterized by an insidious onset with symptoms often including stiffness or weakness in one or both legs, back pain, urinary incontinence, and mild sensory changes. Onethird of patients are bedridden by ten years. Both ATL and HAM occur in 2-5% of HTLVinfected patients. ATL is slightly more common in infected males and usually occurs after 20-30 years of infection whereas HAM is more prevalent among females and can occur just a few years after infection. More than 95% of patients with ATL and HAM have evidence of HTLV-I infection. The patient under discussion was educated about the nature of HTLV-1 and how it differed from HIV, and counselled to practice``safer sex'', avoid donating blood, and, should she become pregnant, avoid breast feeding. She was also informed of the risk, albeit a fairly low one, of ATL and HAM. 2) Identify the diagnostic criteria for eosinophilic gastroenteritis.