Article
15 November 1990

Infection with Human Immunodeficiency Virus Type 1 (HIV-1) among Recipients of Antibody-Positive Blood Donations

Publication: Annals of Internal Medicine
Volume 113, Number 10

Abstract

Objective: To assess the incidence of human immunodeficiency virus type 1 (HIV-1) transmission by antibody (anti-HIV-1)-positive blood components, and to determine the immunologic and clinical course in HIV-1-infected recipients.
Design and Subjects: We retrospectively tested approximately 200 000 donor blood component specimens stored in late 1984 and 1985 for anti-HIV-1, and we contacted recipients of positive specimens to determine their serologic status. They were compared with both recipients of HIV-1-negative transfusions and healthy (untransfused) controls. Subjects were seen at 3- to 6-month intervals for up to 4 years for clinical and immunologic evaluations.
Measurements and Main Results: Of 133 recipients, 9 had other possible exposures. Excluding these cases, 111 of 124 (89.5%) were anti-HIV-1-positive (95% CI, 84.1% to 94.5%). The recipient's sex, age, underlying condition, and type of component did not influence infection rates. The cumulative risk for developing the acquired immunodeficiency syndrome (AIDS) within 38 months after transfusion was 13% (CI, 7.5% to 21.6%). At 36 ± 3 months after the index transfusion, seropositive recipients had lower counts of CD2+CDw26+, CD4+, CD4+CD29+, and CD4+CD45RA+ subsets and more CD8+I2+ lymphocytes than did recipients of anti-HIV-1-negative transfusions. The CD4+ and CD2+CDw26+ subsets changed the most rapidly. The absolute CD8+ count remained normal.
Conclusions: Transfusion of anti-HIV-1-positive blood infected 90% of recipients. The rate of progression to AIDS within the first 38 months after infection was similar to that reported for homosexual men and hemophiliacs. Although most lymphocyte subset counts changed over time, CD8+ counts were constant.

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Information & Authors

Information

Published In

cover image Annals of Internal Medicine
Annals of Internal Medicine
Volume 113Number 1015 November 1990
Pages: 733 - 739

History

Published in issue: 15 November 1990
Published online: 1 December 2008

Keywords

Authors

Affiliations

Elizabeth Donegan, MD
Joyce C. Niland, PhD
Henry S. Sacks, MD, PhD
Stanley P. Azen, PhD
Shelby L. Dietrich, MD
Cheryl Faucett, MS
Mary Ann Fletcher, PhD
Steven H. Kleinman, MD
Eva A. Operskalski, PhD
Herbert A. Perkins, MD
Johanna Pindyck, MD
Eugene R. Schiff, MD
Daniel P. Stites, MD
Peter A. Tomasulo, MD
James W. Mosley, MD
Transfusion Safety Group
From the University of California, San Francisco, California; University of Southern California, Los Angeles, California; Mount Sinai Medical Center, New York, New York; Huntington Memorial Hospital, Pasadena, California; the University of Miami, Miami, Florida; the American Red Cross Blood Services, Los Angeles-Orange Counties Region, Los Angeles, California, and South Florida Region, Miami, Florida; Irwin Memorial Blood Centers, San Francisco, California; and the New York Blood Center, New York, New York. For current author addresses, see end of text.
*
Members of the Transfusion Safety Study Group are listed in the Acknowledgments section at the end of text.

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Elizabeth Donegan, Maria Stuart, Joyce C. Niland, et al; Transfusion Safety Group. Infection with Human Immunodeficiency Virus Type 1 (HIV-1) among Recipients of Antibody-Positive Blood Donations. Ann Intern Med.1990;113:733-739. doi:10.7326/0003-4819-113-10-733

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