Trends in transfusion‐associated acquired immune deficiency syndrome in the United States, 1982 through 1991

Abstract

To evaluate the efficacy of measures for preventing the transmission of human immunodeficiency virus (HIV) by blood transfusion, trends in transfusion-associated cases of acquired immune deficiency syndrome (AIDS) reported through June 1992 were analyzed. By year of transfusion, cases rose from 56 in 1978 to 714 in 1984, dropped sharply to 288 in 1985 when screening of donated blood for HIV antibody began, and fell below 20 per year from 1986 through 1991. Reinvestigation of a sample of cases suggested that only one-fourth of those attributed in the trends analysis to post-1985 United States transfusions actually were due to that source. By year of AIDS diagnosis, cases climbed from 14 in 1982 to 824 in 1987 and subsequently remained relatively level. Of cases diagnosed in 1991 with known transfusion dates, almost all resulted from transfusions received before 1986. Cases in persons aged > or = 65 years at diagnosis fell steeply after 1987, while those in persons aged 45 to 64 years leveled and those in persons aged 25 to 44 years continued to increase; this caused the median age to decrease from 59 in 1986 to 47 in 1991. Thus, screening and other measures have almost completely prevented transmission, but, because of infections acquired before screening began, many cases continue to be diagnosed among increasingly younger persons.

Safety of the Canadian blood supply in 1980–85: using a paediatric cohort for risk assessment of human immunodeficiency virus (HIV) infection

“…Interval estimates for the rate of HIV infection in Table 1 show that the rates observed in 1980–85 are consistent with a gradually increasing risk, and that the apparent dip in 1984 represents believable variation in the occurrence of this rare event. Based on the US estimates, one would have expected a peak rate in 1983 or 84 4 , 5 . In a Canadian model described by Remis et al ., 6 the HIV prevalence rate in donors was estimated to continue to increase throughout the period from 1980 to 1985.…”

Trends in incidence of AIDS associated with transfusion of blood and blood products in Europe and the United States, 1985-93

“…As in the United States8 9 improvements were seen earlier in children largely because they have the shortest incubation period between infection and AIDS diagnosis18 19 20 21 and partly on account of the constraints of the incubation period imposed on this group by the definition of the age limit of 12 years. Some less encouraging patterns are, however, present among adults, with persisting upward trends in Denmark, Italy, and Spain.…”

“…Between 1983 and 1985 major steps were taken to control a bloodborne HIV epidemic,2 but the schedules and the degree of adoption of these measures have been different in various European countries as compared with in the United States 3 4 5 6 7 8 9 10…”

25 Years of HIV in New York City: Lessons from Surveillance

“…Prevention measures such as blood supply screening; decline in needle sharing and needle exchange; safer sexual practices, including use of barrier protection; and zidovudine (ZDV) prophylaxis for pregnant women, have resulted in changes easily observed through surveillance data: the downturn in AIDS in white men who have sex with men and IDUs; the absence of new cases of AIDS associated with blood products/transfusions, the decline in the number of HIV-infected children, and the low HIV incidence in IDUs over the past decade. 3,21,28 Recent advances in antiretroviral therapy have lengthened survival in persons with HIV and delayed progression from HIV infection to AIDS. However, progression to AIDS continues, as evidenced by the rising number of New Yorkers diag-nosed and living with AIDS (Fig.…”

“…2 Success in HIV prevention is evidenced by declining HIV seroprevalence in many groups, disappearance of infections related to blood and blood products, and near elimination of mother-to-child transmission of HIV. 3,4 This report details what is known about the first 25 years of HIV in New York City, from public health surveillance, including AIDS surveillance, HIV-related mortality, and HIV serosurveys. Changes in the epidemic over time have led to changes in public health surveillance.…”