Advisory Committee on the Virological Safety of Blood explained

Advisory Committee on the Virological Safety of Blood
Abbreviation:ACVSB
Successor:Microbiological Safety of Blood and Tissues (MSBT)[1]
Formation:8 March 1989[2]
Founder:Dr H. H. Gunson, and DHSS[3]
Location Country2:United Kingdom
Defunct:February 1993[4]
Type:Advisory
Focus:Blood safety, maintaining adequate blood supplies, testing and screening of blood donors
Key People:Dr E L Harris (chair);
Dr J Metters (chair from August 1989)[5]

The Advisory Committee on the Virological Safety of Blood, often abbreviated to ACVSB,[6] was a committee formed in March 1989 in the United Kingdom to devise policy[7] and advise ministers[8] and the Department of Health on the safety of blood with respect to viral infections.[9] The scope of the ACVSB concerned areas of significant policy for the whole of the United Kingdom and operated under the terms of reference: "To advise the Health Departments of the UK on measures to ensure the virological safety of blood, whilst maintaining adequate supplies of appropriate quality for both immediate use and for plasma processing."[10] Of particular emphasis to the remit was the testing of blood donors using surrogate markers for Non-A Non-B hepatitis (NANBH)[11] and later on, HCV-screening of blood donors.

The first meeting took place on 4 April 1989 and was chaired by the (then) Deputy Chief Medical Officer (DCMO), Dr E L Harris.[12] [13] From August 1989, Dr J Metters, also DCMO, sat as chair. The advice to be given by the committee extended to blood products and donor organs as well as blood, and the viral agents to be considered by the group were HIV1 and HIV2, HTLV-I, Non A Non B Hepatitis, CMV, parvovirus and the prion disease Creutzfeldt–Jakob disease (CJD).

Meetings

After the inaugural meeting of 4 April 1989, the advisory committee met a further 13 times, with the fourteenth meeting being held on 29 September 1992. The files and minutes of the committee do not continue beyond February 1993 by which time the ACVSB was considered defunct. Following a memorandum from NHS Management Executive dated 8 February 1993, the ACVSB was replaced by the committee on the Microbiological Safety of Blood and Tissues (MSBT).[14]

Meetings of the ACVSB
Meeting Date Topics discussed
First meeting 4 April 1989Creutzfeldt-Jakob Disease, the EC directive on blood products, HTLV-I testing.
Second meeting 22 May 1989[15] HTLV-I, Non A Non B hepatitis, Human Growth Hormone, EC directive on blood products, overview on hepatitis, hepatitis B, Non A Non B hepatitis.[16]
Third meeting 3 July 1989[17] EC directive on blood products, HGH, HTLV-I, Non A Non B hepatitis, action in response to reports of blood/blood product infectivity, effect of gamma irradiation on the Human Immunodeficiency Virus and human coagulation proteins.[18]
Fourth meeting 6 November 1989[19] Human Growth Hormone, EC directive on blood products, HTLV-I screening, Non A Non B hepatitis, report on UKBTS survey of surrogate testing and Chiron screening.
Fifth meeting 17 January 1990[20] Human Growth Hormone, EC directive on blood products, HTLV-I screening, Non A Non B hepatitis, combined HIV 1 and HIV2 testing.
Sixth meeting 24 April 1990[21] EC directive on blood products, HIV 1 and 2 testing, Hepatitis C, anti HCV testing.
Seventh meeting 2 July 1990Hepatitis C testing, anti-HCV ELISA tests, chimpanzee study of Anti-HCV tested source plasma.[22]
Eighth meeting 21 November 1990[23] Hepatitis C testing, counselling of HCV positive donors, anti-HBc testing, reinstatement of donors found to be reactive in previously-used HIV screening tests, HCV in the community.
Ninth meeting 25 February 1991[24] Hepatitis C: UKBTS pilot study, NIBSC meeting on Hepatitis C, protocol for HCV Screening and supplementary testing, EC directive on viral safety, EC directive on blood products, hepatitis C: Community transmission, anti-HBc testing of blood donors, hepatitis BsAg confirmatory testing, chronic fatigue syndrome (ME) and blood transfusion, CJD agent/prions in blood donors.[25]
Tenth meeting 21 May 1991[26] Protocol for hepatitis C screening and supplementary testing, anti-HCV tests on blood donations.
Eleventh meeting 29 October 1991[27] Hepatitis C, screening of non UK plasma in blood products, results of first HCV testing trials, ALT testing, use of plasma from anti-HBc positive donors with a history of jaundice, re-admittance of donors not confirmed HIV antibody positive, HTLV-I BTS study, possible look-back study.[28]
Twelfth meeting 21 February 1992[29] Funding anti-HCV screening, chronology of HCV testing, preliminary analysis of HCV testing, evaluation of in-vitro diagnostics by PHLS, non HCV-tested plasma, EC directive on blood products, ALT testing of blood and plasma, HTLV-I testing of blood donations, non-viral infections of blood transfusions including Yersinia, hepatitis A, virally inactivated fresh frozen plasma.
Thirteenth meeting 2 July 1992Anti-HTLV testing/screening, virus inactivated plasma (VIP), initial screening and alternatives to PCR/RIPA confirmatory tests.
Fourteenth meeting 29 September 1992Detection of parvovirus B19 in blood products.[30]

Destruction of files

It came to light in 2004 that documentation that fell within the scope of NHS contaminated blood products had gone missing from within the Department of Health and was thought to have been destroyed in the early 1990s.[31] It was claimed by the (then) Minister of State, Lord Warner, that the files in question had been identified by the Department of Health as minutes and background papers of the ACVSB spanning May 1989 to February 1992 and that they were "unfortunately destroyed" having not been properly archived.[32] In May 2006, it was recorded in Hansard that officials became aware of the destruction of the files as early as April 2000, at which point the Department of Health undertook an internal audit.[33] According to a report in The Times of 13 May 2019, there were 17 volumes of papers generated by the advisory committee during the course of its operation. The investigation by the Department's internal auditors conducted in April 2000 found that of the 17 volumes, 14 had been destroyed and only volumes 1-3 survived.[34] A court disclosure list from the Hepatitis C Litigation dated 9 May 2000 also confirms that ACVSB volumes 4-17 of file series "GEB1" were destroyed at various stages between July 1994 and March 1998.[35]

Key decisions

A significant decision made by the committee in November 1990 was to recommend to Ministers that routine anti-HCV screening of blood be introduced. However, the ACVSB decision was not implemented until September 1991 which came under criticism in the Final Report of the Penrose Inquiry for having been delayed by 10 months.[36] [37] In 2001, the role of the ACVSB was referred to in the judgment of A and Others v National Blood Authority in that ministerial approval had been given on 21 January 1991, yet the second generation tests were not introduced in England and Wales until 1 September 1991.[38]

During the HIV Haemophilia Litigation, the ACVSB recommended the use of a waiver, or deed of undertaking, aimed at ensuring that the claimants would not be able to litigate against the government if they were found to have contracted any further viruses.[39] [40] It was recorded in Hansard in 2007 that a number of these deeds of undertaking from 1989 were inadvertently destroyed.[41]

See also

Notes and References

  1. Web site: Written Statement of Marc Turner . Turner . Marc . 7 October 2021 . infectedbloodinquiry.org.uk . Infected Blood Inquiry . 23 January 2022 . WITN3530007 . Prior to the formation of SaBTO advice was provided at UK Government level by the Committee for the Microbiological Safety of Blood, Tissues and Organs (MSBTO) and its predecessor, the Committee for the Microbiological Safety of Blood and Tissues (MSBT) (1993 -2007). Prior to that we understand that advice was provided on a national level by a body called the Advisory Committee on the Virological Safety of Blood (ACVSB)..
  2. A & Ors v National Blood Authority & Ors . QB . 446 . 100 . EWHC . 2001 . https://www.bailii.org/ew/cases/EWHC/QB/2001/446.html . The Department confirmed to Dr Gunson on 8 March 1989, when it set up the ACVSB....
  3. 2010 . Preliminary Report . Penrose Inquiry . para 9.34 . 23 January 2022 . Dr Gunson had recommended to the DHSS that a group should be established and this had been agreed..
  4. News: Burgess . Kaya . Halle . Martyn . 13 May 2019 . Bereaved families fear blood scandal cover‑up by officials . . London . 24 January 2022 . The committee produced 17 volumes of documents and the files were closed in February 1993..
  5. Web site: Dr Jeremy Metters (scheduled to give evidence 14th July 1998) . Metters . Jeremy . 14 July 1998 . bseinquiry.gov.uk . BSE Inquiry . 23 January 2022 . No 116 . I have also been Chairman of the Advisory Committee of the Virological Society of Blood (ACVSB) since August 1989..
  6. . 446 . 11 . EWCH . 2001 . https://www.bailii.org/ew/cases/EWHC/QB/2001/446.html . ...and reported back to the two high powered committees on which he sat, the UK Advisory Committee on Virological Safety of Blood ('ACVSB'), and the UK Advisory Committee on Transfusion Transmitted Diseases ('ACTTD')....
  7. Web site: Note of Meeting of the Advisory Committee on the Virological Safety of Blood held at Hannibal House . . 4 April 1989 . penroseinquiry.org.uk . 23 January 2022 . The task of the Advisory Committee was to devise policy....
  8. Advisory Committee on the Virological Safety of Blood . 4 April 1989 . Minutes of the First Meeting on 4 April 1989 at the Department of Health . Penrose Inquiry . SNF.001.1219 . 23 January 2022 . He explained that the Committee had been set up to give advice to the UK Health Ministers..
  9. 2010 . Preliminary Report. https://www.penroseinquiry.org.uk/preliminary-report/chapter-9/index.html . Penrose Inquiry . 9 - Hepatitis 1986 to date . 22 January 2022 . The ACVSB advised the UK government, among other things, on surrogate testing of blood donors for NANB Hepatitis and screening of donors for Hepatitis C..
  10. Web site: Advisory Committee on the Virological Safety of Blood . Terms of Reference . Penrose Inquiry . SNB.001.9366 . penroseinquiry.org.uk . 23 January 2022 .
  11. Health Committee . 2001 . Follow Up Submission by the Scottish National Blood Transfusion Service . Scottish Parliament . SP Paper 398 . 23 January 2022 . Surrogate testing of blood donations in relation to Non A Non B hepatitis formed an important part of its business..
  12. Web site: Advisory Committee on the Virological Safety of Blood - Members . penroseinquiry.org.uk . Penrose Inquiry . SNB.001.9364 . 23 January 2022 .
  13. 19 October 2021 . Written Statement of Dr Gail Miflin (NHSBT) . Infected Blood Inquiry . 218 . WITN0672006 . 23 January 2022 . The ACVSB first met on 4 April 1989..
  14. Web site: Advisory Committee on the Microbiological Safety of Blood and Tissue for Transplantation (MSBT) . Tucker . G W . 8 February 1993 . penroseinquiry.org.uk . Penrose Inquiry . SGH.003.1137 . 26 January 2022 .
  15. Web site: A38112 Schedule of Questions . penroseinquiry.org.uk . Penrose Inquiry . SNF.017.2159 . 25 January 2022 . Each group met in May 1989: the ACTTD had its second meeting on 19 May and the ACVSB its second meeting on 22 May..
  16. Web site: Minutes of the Second Meeting Held on 22 May 1989 . 22 May 1989 . penroseinquiry.org.uk . Penrose Inquiry . SNB.001.9416 . 26 January 2022.
  17. Web site: A & Ors v National Blood Authority & Ors . 26 March 2001 . casemine.com . 25 January 2022 . The report was given to the third meeting of the ACVSB on 3 July 1989....
  18. Web site: Minutes of the 3rd Meeting of 3 July 1989 . 3 July 1989 . penroseinquiry.org.uk . Penrose Inquiry . SNB.001.9513 . 26 January 2022.
  19. Web site: Department of Health and Social Security . 30 October 1989 . penroseinquiry.org.uk . Penrose Inquiry . SNF.001.1383 . 25 January 2022 . Below is the agenda for the 4th meeting of the ACVSB, to be held at 1030hrs Monday 6 November 1989....
  20. Web site: Fifth Meeting of Advisory Committee on Virological Safety of Blood . 17 January 1990 . penroseinquiry.org.uk . Penrose Inquiry . SNF.001.1491 . 25 January 2022.
  21. Web site: Minutes of the 6th meeting held on 24 April 1990 . 24 April 1990 . penroseinquiry.org.uk . Penrose Inquiry . SNB.001.9761 . 26 January 2022.
  22. Web site: Seventh Meeting of the Advisory Committee on Virological Safety of Blood . 2 July 1990 . penroseinquiry.org.uk . Penrose Inquiry . SNF.001.1706 . 26 January 2022.
  23. Web site: Minutes of the 8th Meeting held on 21 November 1990 . 21 November 1990 . penroseinquiry.org.uk . Penrose Inquiry . SNB.001.1777 . 26 January 2022.
  24. Web site: Minutes of the 9th Meeting held on 25 February 1991 . 25 February 1991 . penroseinquiry.org.uk . Penrose Inquiry . SNB.001.8934 . 26 January 2022.
  25. Dr H Pickles . 2 January 1991 . ACVSB paper: Prions & Blood . BSE Inquiry . nationalarchives.gov.uk . YB 91/1.2/2.7 (BSE21/1 0074) . 29 January 2022.
  26. Web site: Tenth Meeting of the Advisory Committee on the Virological Safety of Blood . 21 May 1991 . penroseinquiry.org.uk . Penrose Inquiry . SNB.001.9107 . 26 January 2022.
  27. Web site: Minutes of the Eleventh Meeting Held on 29 October 1991 . 29 October 1991 . penroseinquiry.org.uk . Penrose Inquiry . SNB.001.9148 . 26 January 2022 .
  28. Web site: Professor Bloom and Cardiff Haemophilia Centre - Inquiry Presentation . Ms Richards . 24 September 2020 . 79 . Infected Blood Inquiry . 31 January 2022 . ...and then we have in October of 1991 an 11th meeting of that committee, the Advisory Committee on the Virological Safety of Blood considering recommendations in relation to HCV testing and the results of the first HCV test trials and the possibility of look-back study although no decision then taken.....
  29. Web site: Minutes of the Twelfth Meeting of the Advisory Committee on the Virological Safety of Blood . 21 February 1992 . penroseinquiry.org.uk . Penrose Inquiry . SNB.001.9204 . 26 January 2022.
  30. Web site: ACVSB Minutes - Parvovirus B19 Contamination of Factor Products . 2006 . taintedblood.info . TaintedBlood . 27 January 2022 . "Dry heat treatment of 8O°C for 72 hours reduced but did not always eliminate detectable B19 from factor VIII concentrates, consistent with recent observations that current methods of viral inactivation during blood product manufacture are insufficient to entirely eliminate B19 infectivity..
  31. Dr Gavin Colthart . 13 July 2011 . HIV and Hepatitis C infection from contaminated blood and blood products . House of Commons Library . 22 . SN/SC/5698 . 28 January 2022.
  32. NHS: Contaminated Blood Products . House of Lords . 27 February 2006 . WA26 . WA27 . Lord Warner . The Minister of State, Department of Health.
  33. Destroyed Documents (Blood Products) . House of Commons . 23 May 2006 . 1742W . 1743W . Caroline Flint . Minister of State for Public Health.
  34. April 2000 . Hepatitis C Litigation - Final Report . https://web.archive.org/web/20220129051521/https://static1.squarespace.com/static/58a18aeb2e69cf7248eeddbc/t/5b1a74a9352f53bcbf9a4c8c/1528460512936/DH+Audit+on+GEB.pdf . 2022-01-29 . Department of Health . 6 . Squarespace.com . 29 January 2022 . ...although volumes 14-17 were destroyed, volumes 1-3 survive....
  35. Web site: Third Written Statement of Charles Lister OBE . Lister . Charles . 19 May 2022 . infectedbloodinquiry.org.uk . Infected Blood Inquiry . 26 . WITN4505389 . 29 June 2022.
  36. Web site: Carrell. Severin. Perraudin. Frances. 2015-03-25. Cameron apologises to those infected with hepatitis C and HIV 30 years ago. 2022-01-31. the Guardian. en. Penrose ruled that, overall, little could have been done differently by the authorities to prevent the contamination, but that mistakes were made. He criticised a 10-month delay in 1990 by the advisory committee on the virological safety of blood to recommend that screening start....
  37. Web site: Final Report: Chapter 31 - The Introduction of Screening of Donated Blood for Hepatitis C. 2022-01-31. www.penroseinquiry.org.uk. The Inquiry has endeavoured to assess why there was a delay of almost 10 months between the decision by the ACVSB on 21 November 1990 to recommend the introduction of screening as soon as practicable and 1 September 1991....
  38. Web site: 2001. A & Ors v National Blood Authority & Ors [2001] EWHC QB 446 (26th March, 2001)]. 2022-01-31. www.bailii.org. Recommendations to proceed with the introduction of the anti-Hep C testing were made by the relevant UK Committee, the ACVSB, in July and November 1990, subject to the holding of various trials. Ministerial approval was given on 21 January 1991 and a programme of implementation was then commenced for all RTCs. The tests (by now second generation tests, and with a supplementary test available for confirmatory purposes in place) were introduced throughout England and Wales on 1 September 1991..
  39. News: Selby. Alan. 27 September 2020. Shred of Evidence; Fury at HIV blood scandal 'cover-up'. 28. The People. London. 31 January 2022. The ACVSB had advised ministers to require victims to sign a waiver agreeing not to pursue the Government over hepatitis infections when applying for compensation..
  40. Burgess. Kaya. Halle. Martyn. 13 May 2019. Bereaved families fear blood scandal cover-up by officials. The Times (London, England). English. 21. 31 January 2022. It is also believed that the committee was responsible for suggesting that those who had been infected with HIV and wanted compensation should sign a waiver agreeing not to sue if they were later found to have contracted other viruses.. Gale.
  41. Blood: Contamination . House of Commons . 14 May 2007 . 571W . 573W . Caroline Flint . Minister of State for Public Health . A number of signed waivers, going back to 1989, were inadvertently destroyed with the files in which they were held..

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