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April 2011 Newsletter 
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Transfusion-Transmitted HIV Infection from Missouri Blood Donor
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Updated Test Interpretations

 

Bordetella Pertussis PCR 

 

DDimer for DIC 

 

DDimer for DVT 

 

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Immunofixation 

 

Hypercoagulable Panel 

  

New Transfusion Articles

 

Neonatal Alloimmune Thrombocytopenia 


 

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Essentials of Transfusion Medicine (Volume 1)
by Fred V. Plapp MD PhD by BookSurge Publishing
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Transfusion-Transmitted HIV Infection from Missouri Blood Donor

The current risk for acquiring HIV infection from a blood transfusion is estimated at 1 in 1.5 million. Screening for HIV infected blood products includes enzyme immunoassay for HIV 1/2 antibody, as well as HIV nucleic acid testing (NAT) performed on a sample from every donation, prior to any products' release for transfusion. 

 

Recently, CDC described the first U.S. case of transfusion-transmitted HIV infection reported since 2002 (MMWR October 22, 2010 / 59(41);1335-1339). In November 2008, a donation at a Missouri blood center tested positive for HIV infection. Through a lookback process, the same donor was found to have donated in June 2008. Products from the June 2008 donation were transfused to two different recipients. One of the recipients died 2 days post-transfusion due to cardiac surgery complications. The other recipient received fresh frozen plasma during a kidney transplant. This recipient was subsequently found to be HIV-infected.  Sequencing of the donor & recipient's HIV strain by the CDC confirmed them to be identical viruses.

Repeat testing of specimens from the June 2008 donation confirmed the absence of detectable HIV infection. NAT testing can detect HIV infection as early as 10-15 days after infection, therefore the donor is presumed to have been in the interval between acute infection and having detectable HIV RNA at the time of donation. Further questioning of the donor revealed he incorrectly answered pre-donation questions which would have categorized him at high risk for HIV infection & excluded him from donation.

This case is a reminder that even though the blood supply is extremely safe, a small percentage of patients continue to experience serious adverse transfusion reactions. The best way to minimize risk is to order a transfusion only when absolutely necessary.

 

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