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Transmission of Human Immunodeficiency Virus (HIV) by Transplantation: Clinical Aspects and Time Course Analysis of Viral Antigenemia and Antibody Production

P. ALLEN BOWEN II, M.D.; STEVEN A. LOBEL, Ph.D.; RALPH J. CARUANA, M.D.; MARY S. LEFFELL, Ph.D.; MARY A. HOUSE, R.N., M.S.N.; J. PETER RISSING, M.D.; and ARTHUR L. HUMPHRIES, M.D.
[+] Article and Author Information

▸Requests for reprints should be addressed to P. Allen Bowen, II, M.D.; Medical College of Georgia, Nephrology Section, Room N915; Augusta, GA 30912.


© 1988 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1988;108(1):46-48. doi:10.7326/0003-4819-108-1-46
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The human immunodeficiency virus (HIV) was transmitted to a patient who received a cadaveric renal transplant from a donor who had received massive blood component replacement. A negative HIV antibody test was obtained on serum drawn immediately after transfusion. After transplantation, pretransfusion sera and sera obtained several hours after transfusion tested positive for HIV antibody, suggesting that transfusions had transiently diluted the patient's serum and resulted in a false-negative HIV antibody test. Immediately after transplantation, the recipient showed a transient increase in HIV antigen levels followed by a more sustained increase representing de-novo antigen synthesis. Antibodies to HIV were detected 51 days after transplant. The recipient has shown no signs or symptoms of HIV infection after 1 year. In potential cadaveric organ donors, HIV antibody testing should be performed on pretransfusion sera or on sera obtained several hours after massive transfusion of blood products.

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