Risk of AIDS for recipients of blood components from donors who subsequently developed AIDS

Abstract

Reported cases of acquired immunodeficiency syndrome (AIDS) in San Francisco as of March 31, 1986, include 92 individuals who had donated blood subsequent to 1978. Their donated blood components had been transfused into 406 different recipients. The current status of 336 of these recipients was ascertained as of April 1, 1986. Of these, 223 had died at the time of our first contact, almost all as a result of the condition for which they were transfused. Seven had developed AIDS; five of these died, two before entry into the study and three subsequently. Forty-six additional living recipients were interviewed and evaluated. Seven had the AIDS-related complex, 18 had antibody to the human immunodeficiency virus (HIV) but were otherwise healthy, and 19 had no detectable anti-HIV. Two had risk factors other than transfusion. The frequency of infection of the recipient decreased as the time interval between transfusion and the diagnosis of AIDS in the donor increased. This information should be useful when counseling patients who have been transfused with blood components from donors later found to be infected with HIV.

Length of survival after perioperative transfusion

“…Therefore, in evaluating perioperative transfusion as a medical practice competing for scarce health care resources with other interventions (AuBuchon, 1996), analysts can infer from the data in this study that transfusion is by far more cost-effective than would be implied by data limited to tertiary-care medical centres. Studies from the latter settings reported that most transfused patients die within 2 years of the transfusion (Ward et al, 1989), and that the average interval between transfusion and death is 10 months (Perkins et al, 1987).…”

“…prevention of transfusion-transmitted diseases and avoidance of the immunological effects of allogeneic transfusion; Royal College of Physicians of Edinburgh, 1996). Post-transfusion lengths of survival are also affected by the patient population studied, because patients referred to tertiarycare medical centres (Perkins et al, 1987;Ward et al, 1989) may have a more severe illness -and a shorter post-transfusion life expectancy -than unselected patients transfused at community hospitals.…”

Transmission of Lymphotropic Retroviruses (HTLV‐I and LAV/HTLV‐III) by Blood Transfusion and Blood Products

“…In a study of this matter with 27 donors, who after their donation developed AIDS, it was found that blood components from the donors had been transfused into 12 1 different recipients. Sixty-four of these recipients are dead from their original or an unrelated illness and 2 from AIDS [75]. Forty-one are alive and 14 could not be located.…”

Transmission Rates and the Evolution of HIV Virulence

“…This evolutionary process leads eventually to the development of AIDS after a variable incubation period. So, the pressures favoring the evolution of fast viral reproduction when sexual contact is high and of delayed viral reproduction when sexual contact is low provide the basis for a prediction: HIV virulence should be correlated with rates of sexual contact (Ewald 1994).Actually, literature concerning the capacity of HIV variants to induce AIDS (and eventually kill their hosts) with different rates show that AIDS progression is associated with the history of sexual intercourse (Perkins et al 1987;Ward et al 1989;van Griensven et al 1990;Blower and Boe 1993; Ewald 1994).Obviously, the rationale exposed above is also valid for parenteral transmission of HIY. As the number of people sharing injecting equipment, as well as the rate of exchanges increase, the fast replicator strains of HIV are favored.…”

“…Actually, literature concerning the capacity of HIV variants to induce AIDS (and eventually kill their hosts) with different rates show that AIDS progression is associated with the history of sexual intercourse (Perkins et al 1987;Ward et al 1989;van Griensven et al 1990;Blower and Boe 1993; Ewald 1994).…”