Evaluation of screened blood donations for human immunodeficiency virus type 1 infection by culture and DNA amplification of pooled cells

Article Abstract:

Although blood donations are routinely screened for contamination with the human immunodeficiency virus type 1 (HIV-1), there are reports of HIV-1 transmission from screened blood. After infection with HIV, which causes AIDS, the body produces antibodies, or immune proteins, that are specifically directed against HIV-1. These HIV-1-specific antibodies in the blood serve as a marker for HIV-1 infection. However, HIV-1-specific antibodies may not always be detected in HIV-infected persons, and this may have serious implications regarding the safety of the blood supply. It was estimated that the risk of HIV transmission ranged between 1 in 38,000 and 1 in 300,000 per unit of blood. However, these estimates were based on the ability to show seroconversion, or the presence of HIV-1-specific antibodies in the blood of HIV-1-infected patients. The risk of HIV-1 transmission from blood transfusions was assessed by testing screened blood for HIV-1 using viral culture and the polymerase chain reaction. In viral culture, cells in the blood sample are exposed to laboratory conditions that are ideal for viral growth. If viruses can be grown in culture, the sample is considered to be infected with HIV-1. In the polymerase chain reaction, portions of DNA from cells in the blood sample are copied, producing amounts of DNA that are adequate for analysis and identification. If DNA from HIV-1 is identified, the blood sample is considered to contain HIV-1. Of 1,530 pools of blood cells from 76,500 blood donations made in San Francisco between November 1987 and December 1989, 1,436 were cultured successfully and 873 were tested by the polymerase chain reaction. HIV-1 infection was confirmed in only one case by both viral culture and the polymerase chain reaction. The probability that a screened blood donor will be HIV-positive was estimated at 1 in 61,171. The findings suggest that the risk of HIV-1 transmission from blood transfusion is very low, even in cities where HIV-1 infection is prevalent. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Methods, Evaluation, Blood collection and preservation, Blood donors, Blood donation

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The natural history of transfusion-associated infection with human immunodeficiency virus: factors influencing the rate of progression to disease

Article Abstract:

For physicians interested in studying the time course of the HIV (human immunodeficiency virus) infection from first transmission of the virus to development of AIDS, establishing a firm time-line is often difficult. Usually the actual time of infection and its source are unknown. However, for those patients infected by transfusion the time and the identity of the source is accurately established. These unfortunate victims provide the medical community with its best clinical source of information concerning the natural biology of the AIDS virus. The progress of 694 individuals who received blood from 143 donors who were later found to be infected with HIV was followed. Approximately half of the transfusion recipients were dead within one year; a similar percentage of patients in the study receiving transfusions not infected with HIV were also dead within one year. Of remaining recipients, not all could be followed; of those tested for AIDS, 85 showed no infection at the time of testing and 116 were identified as infected with HIV (19 of whom already had developed AIDS). Further studies of the patients' white blood cells and other clinical findings indicated the stage of their infection. Extrapolation of previous work and data from these patients allows an estimate that approximately one half of these infected recipients will develop AIDS within seven years of the time of their transfusion. Donors were grouped into two classes, those who developed AIDS within 29 months of the time of donation (early), and those who developed AIDS after that time (late). Recipients of blood from the early group of donors were more likely to have AIDS four years after transfusion.

Research, Case studies, Complications and side effects, Medical screening, Health screening, Health risk assessment, Blood transfusion, Blood banks, HIV antibodies

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National HIV case reporting for the United States: a defining moment in the history of the epidemic

Article Abstract:

The collecting of comprehensive and anonymous HIV test reports are needed to further scientific knowledge about the disease while maintaining the privacy of infected individuals. HIV test data can help identify pockets of infection, channel treatment funding equitably, and monitor disease risk and infection characteristics. Anonymous data collection can be accomplished by providing remote test sites, using home test kits, and encoding identifiable patient information. Infected patients identified early can be directed to appropriate services and may benefit from early treatment.

HIV infection, HIV infections, Ethical aspects, HIV testing, HIV tests, Disease reporting

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