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 Leslie H. Tobler, Dr. P.H.
Current Positions:
- Senior Scientist, BSRI
- Lecturer, San Francisco State University, Department of Biology
- Lecturer, San Francisco State University, Department of Nursing
Contact Information:
270 Masonic Ave.
San Francisco, CA 94118
Phone: (415) 749-6609
Fax: (415) 775- 3859
Email: ltobler@bloodsystems.org
Download a scientific summary [pdf file]
Download a curriculum vitae [pdf file]
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Education:
- Medical Technology apprenticeship with licensure, Kantonsspital, St. Gallen, Switzerland
- B.S., Medical Technology, California State University, Hayward
- M.P.H., Medical Virology/Immunology, University of California, Berkeley
- Dr. P.H., Medical Virology/Immunology, University of California, Berkeley
Training/Appointments:
- Post-doctoral fellow, University of California Los Angeles Medical Center, Department of Pediatrics, Torrance, CA (Dr. David T. Imagawa)
- Post-doctoral fellow, University of California, San Francisco, Cancer Research Institute, San Francisco, CA (Dr. Jay A. Levy)
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Research Interests:
- HCV Infection
- Implementation of nucleic acid testing (NAT)
- Sensitivity of NAT screening
- The West Nile virus (WNV) epidemic
Current research
REDS I and II
Dr. Tobler’s group has played a key role in laboratory study during the course of Retrovirus Epidemiology Donor Study(REDS) I and II by managing specimen shipments from the REDS –I centers, processing samples and establishing a REDS-I repository. Dr. Tobler’s group also performed special serological assays (WNV, Chagas, Dengue) and distributed samples from the repository to BSRI and academic and commercial collaborators. The Viral Reference and Repository Core (under Dr. Tobler’s oversight) will become a key part of the REDS II Central Laboratory.
Determinants of Transmissibility of Transfusion-transmitted Agents
There are factors (viral, genetic and immunologic) that influence the probability of a blood donation harboring an infectious agent will transmit the infectious agents to its recipient(s). Some studies Tobler’s group assisted with are: 1) testing samples from participants in the of human T-lymphotropic virus (HTLV) cohort to establish the relationship between viral load in the infected donor and secondary transmission to donors’ sexual partners, and 2) examination of the relationship between very low HIV or HCV RNA viral load in infected donations and transmission to recipients.
Evaluation of Laboratory Tests and Algorithms
As tests for new infectious agents are considered or implemented in the blood donor setting, it is important that the performance characteristics of these assays and related testing algorithms are established. Sensitivity, specificity, and predictive values were conducted for: 1) HTLV screening, 2) hepatitis surrogate markers, 3) HIV-1 p24 antigen and Western blot assays, 4) HIV antibody screening and confirmatory tests, and 5) NAT assays for HIV, HCV and WNV.
HCV Studies
Acute HCV Infection in Young Injectors
Dr. Tobler’s group is involved in an on-going study of acute HCV virus infection in young injection drug users in San Francisco. Her group uses serologic and RNA technology methods for early identification of HCV infection that facilitated the understanding of immunologic responses to acute infections and the subsequent rate of clearance of infection (from the body) among newly infected individuals.
HCV Among Prisoners in the California State Correctional System
Dr. Tobler’s group assessed the prevalence of HCV infection among prisoners entering California State correctional facilities and the risk of transmission to prison staff.
HCV Viral Load in Anti-HCV-reactive Donors and
Infectivity for Their Recipients
The group sought to determine when seroconversion takes place and transfusion transmission is possible. This study looked at the sensitivity of NAT mini-pool vs. single-donation testing, and the continued use of serologic testing.
West Nile Virus Studies (WNV) WNV RNA Dynamics and Antibody Evolution Based on Follow-up of Viremic Blood Donors: Screening donors for WNV RNA using NAT in 2003, led to the first detection of blood donors in the early stages of viremic infection. An understanding of the time course and dynamics of WNV RNA and serological markers following acute infection has important implications for donor screening and deferral policies, as well as for diagnosing WNV infection in clinical settings.
Chagas Disease Study
Pre-Clinical Trial of Ortho Clinical-Diagnostic’s Newly Developed Chagas Enzyme Immunoassay (EIA): Chronic Chagas disease imported into the U.S. blood supply by blood donors born in South and Central America, represents a serious blood safety problem. In chronically infected blood donors, the parasite, T. crusi, can be transmitted from one individual to another via blood transfusion.
The objectives of this pre-clinical study were to establish the specificity and sensitivity of this assay among 10,000 sequential donations in an area with a relatively large Hispanic donor subpopulation as well as 180 antibody positive specimens.
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Publications
Zoller L, Tobler L. Vergleich der Keimzahlbestinnung Uricult-Gussplatte. (German) Das Medizinische Laboratorium, 9:214-7, 1969.
Levy JA, Tobler LH, McHugh TM, Cassavant CH, Stites DP. Long-Term Cultivation of T Cells Subsets from Patients with Acquired Immune Deficiency Syndrome. Clin Immunol & Immunopathol, 35: 328-336, 1985.
Tobler LH, Busch MP, Wilber J, Dinello R, Quan S, Polito A, Lochesky R. Bahl C, Nelles M, Lee SR. Evaluation of c22-3 Indeterminate Reacti8vity in Volunteer Blood Donors. Transfusion, 34:130-4, 1994.
Tobler LH, Busch MP. History of Post-Transfusion Hepatitis. Clin. Chem, 43 (8-B, Part 2): 1487-93 , 1997.
Tobler LH, Stramer SL, Lee SR, Masecar BL, Peterson JE, Davis EA, Andrew WW, Brodsky JP, Kleinman SH, Phelps, BH Busch MP. Impact of HCV 3.0 EIA Relative to HCV 2.0 EIA on Blood Donor Screening. Transfusion, 43:14529, 2003.
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