The Current Risk of Retroviral Infections Transmitted by Transfusion in Patients Who Have Undergone Multiple Transfusions

Abstract

The application of reliable screening procedures for donor selection reduced the transmission of transfusion-associated HIV infection in 1989-1995 to fewer than 2 cases in 10,000 person-years or 1 case per 190,000 units of red blood cells.

Detection of Human T-Lymphotropic Virus (HTLV) tax Sequences in New York City Blood Donors Seronegative for HTLV Types 1 and 2

“…The results from this study and the earlier multicenter study (1) suggest that the prevalence of HTLV tax sequences in low-risk blood donors is not as high as previously reported (19,20) and provide additional support that the risk of transmission of HTLV by screened blood products is remote (12,15).…”

Benefits and Complications of Regular Blood Transfusion in Patients with Beta-Thalassaemia major

“…During the follow-up of 1,001 patients, receiving approximately 190,000 red cell units between 1990 and 1996, we identified only one seroconversion, accounting for an incidence of 1.7/10,000 person-years. This corresponds to a risk of 1/190,000 [7], which seems in the same order of magnitude of that calculated in the USA using the incidence/window period model [57]. …”

“…Subsequently, the frequency of HIV infection decreased to 2.9% in 1990 [7, 24], and 1.8% in 1998 [10]. This was due to two main reasons: (a) the efficacy of anti-HIV screening for blood donations, implemented in 1985, and (b) the high mortality among HIV-infected thalassaemics (25% over a 6-year period) [7]. …”

“…At the present time, treated β-TM patients are affected by a different disease, a sort of ‘iatrogenic syndrome’ which needs to be monitored and treated throughout lifetime. Iron overload of tissue and blood-borne infectious agents still represent the principal causes of morbidity and mortality among children and adults with β-TM, despite the sequential introduction of long-term iron-chelating therapy, virological screening of donated blood, and effective antiviral treatments [6, 7, 8, 9, 10]. …”

“…It is based on textbooks [1, 3, 11, 12, 13, 14, 15], review articles [2, 5, 6, 16, 17], searches of PubMed (102 articles were published in 1998 alone), and recent proceedings of symposia of specific interest [18, 19, 20]. Information on viral infections is largely derived from the data of the Cooleycare Cooperative Group, which since 1989 has included a survey programme specifically designed to estimate the transfusion risk and to describe the natural history of blood-borne infections among chronic transfusion recipients [4, 7, 8, 21, 22, 23, 24]. …”