0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Transmission of Retroviruses from Seronegative Donors by Transfusion during Cardiac Surgery: A Multicenter Study of HIV-1 and HTLV-I/II Infections

Kenrad E. Nelson, MD; James G. Donahue, DVM; Alvaro Muñoz, PhD; Noah D. Cohen, VMD, PhD; Paul M. Ness, MD; Anita Teague, RN; Veronica A. Stambolis, MA; David H. Yawn, MD; Betty Callicott, MTACP; Hugh McAllister, MD; Bruce A. Reitz, MD; Helen Lee, PhD; Homayoon Farzadegan, PhD; and Charles G. Hollingsworth, DrPH
[+] Article and Author Information

Grant Support: In part by contract No 1-HB-6-7025 with the National Heart, Lung, and Blood Institute and by a National Institutes of Health Outpatient Clinical Research Centers Grant (5M01RR00722).

Requests for Reprints: Kenrad E. Nelson, MD, The Johns Hopkins University School of Hygiene and Public Health, 624 North Broadway, Room 886, Baltimore, MD 21205.

Current Author Addresses: Drs. Nelson, Donahue, Muñoz, and Farzadegan and Ms. Stambolis: Department of Epidemiology, The Johns Hopkins School of Hygiene and Public Health, 624 North Broadway, Baltimore, MD 21205.

Drs. Reitz and Ness: the Johns Hopkins Hospital, Baltimore, MD.

Dr. Cohen: College of Veterinary Medicine, Texas A&M.University, College Station, TX.

Dr. McAllister and Ms. Teague: Department of Pathology, St. Lukes Episcopal Hospital, Houston, TX.

Dr. Yawn and Ms. Callicott: Department of Pathology, Baylor College of Medicine, Methodist Hospital, Houston, TX. Dr. Lee: Abbott Laboratories, North Chicago, IL.

Dr. Hollingsworth: National Heart, Lung, and Blood Institute, Bethesda, MD.


Ann Intern Med. 1992;117(7):554-559. doi:10.7326/0003-4819-117-7-554
Text Size: A A A

Objective: To evaluate the effectiveness of serologic testing of blood donors for human immunodeficiency virus type 1 (HIV-1) and human T-cell lymphotropic virus types I and Il (HTLV-I/II) infections and to estimate the risk for transmission of HIV-1 and HTLV-I/II by transfusion of seronegative blood from screened donors.

Design: A prospective multicenter cohort study of cardiac surgery patients who received multiple transfusions between 1985 and 1991.

Setting: Cardiac surgery services of three large tertiary care hospitals.

Patients: The study included 11 532 patients in three hospitals who had cardiovascular surgery.

Measurements: Incident HIV-1 and HTLV-I or HTLV-II infection.

Results: We detected two new HIV-1 infections among patients transfused with 120 312 units of blood components from seronegative donors. In each case a donor was detected on follow-up who had seroconverted since the donation. The HIV-1 infection rate was 0.0017% with an upper limit of the 95% Cl of 0.0053%. Before donor screening for HTLV-I, transfusion of 51 026 units resulted in two HTLV-I infections (0.0039%) and four HTLV-II infections (0.0078%). After HTLV-I screening was instituted, one recipient was infected with HTLV-II among participants exposed to 69 272 units, a rate of 0.0014%. A corresponding HTLV-l/ll-infecteddonor was found for this patient.

Conclusion: Serologic screening of donors for antibodies to HIV-1 and HTLV-I coupled with exclusion of donors from groups having a relatively high risk for infection has led to a low incidence of transfusion-transmittedHIV-1 and HTLV-I/II infection in the United States. A small risk remains, however, despite these measures. We estimate the residual risk for HIV-1 and HTLV-II infection from transfusion of screened blood during the time of this study to be about 1 in 60 000 units.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Topic Collections
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)