0 Laughhunn, A. Santa Maria, F. Broult, J. Lanteri, M. Stassinopoulos, A. Musso, D. Aubry, M. 2017 Amustaline (S-303) Treatment Inactivates High Levels of Zika Virus in Red Blood Cell Components Transfusion Accept 2016 <p>The potential for Zika virus (ZIKV) transfusion-transmission (TT) has been demonstrated in French Polynesia and Brazil. Pathogen inactivation (PI) of blood products is a proactive strategy to inactivate TT pathogens including arboviruses. Inactivation of West Nile, dengue, Zika, and chikungunya viruses was previously demonstrated by photochemical treatment with amotosalen and ultraviolet A (UVA) illumination. In this study, we evaluated ZIKV inactivation in red blood cell (RBC) components by a chemical approach that uses amustaline (S-303) and glutathione (GSH).<br />STUDY DESIGN AND METHODS:<br />RBC components were spiked with a high titer of ZIKV. Viral titers (infectivity) and ZIKV RNA loads (reverse transcription-polymerase chain reaction) were measured in spiked RBCs before and after S-303 and GSH treatment and confirmed using repetitive passages in cell culture. A mock-treated arm validated the approach by demonstrating stability of the virus (infectivity and RNA load) during the process.<br />RESULTS:<br />The mean ZIKV infectivity titer and RNA load in RBCs were 5.99 &plusmn; 0.2 log 50% tissue culture infectious dose (TCID50 )/mL and 7.75 &plusmn; 0.16 log genomic equivalents/mL before inactivation. No infectivity was detected immediately after S-303 and GSH treatment and after five serial passages in cell culture.<br />CONCLUSION:<br />Complete ZIKV inactivation of more than 5.99 log TCID50 /mL in RBCs was achieved using S-303 and GSH at levels higher than those found in asymptomatic ZIKV-infected blood donors. Therefore, the S-303 and GSH PI system is promising for mitigating the risk of ZIKV TT.</p>