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M9630643.TXT
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1996-02-27
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Document 0643
DOCN M9630643
TI Estimated risk of transmission of the human immunodeficiency virus by
screened blood in the United States.
DT 9603
AU Lackritz EM; Satten GA; Aberle-Grasse J; Dodd RY; Raimondi VP; Janssen
RS; Lewis WF; Notari EP 4th; Petersen LR; HIV Seroepidemiology Branch,
Centers for Disease Control and; Prevention, Atlanta, GA 30333, USA.
SO N Engl J Med. 1995 Dec 28;333(26):1721-5. Unique Identifier : AIDSLINE
MED/96092302
AB BACKGROUND. In the United States, transmission of the human
immunodeficiency virus (HIV) by blood transfusion occurs almost
exclusively when a recently infected blood donor is infectious but
before antibodies to HIV become detectable (during the window period).
We estimated the risk of HIV transmission caused by transfusion on the
basis of the window period associated with the use of current, sensitive
enzyme immunosorbent assays and recent data on HIV incidence among blood
donors. METHODS. We analyzed demographic and laboratory data on more
than 4.1 million blood donations obtained in 1992 and 1993 in 19 regions
served by the American National Red Cross, as well as the results of
HIV-antibody tests of 4.9 million donations obtained in an additional 23
regions. RESULTS. We estimated that, in the 19 study regions, 1 donation
in every 360,000 (95 percent confidence interval, 210,000 to 1,140,000)
was made during the window period. In addition, it is estimated that 1
in 2,600,000 donations was HIV-seropositive but was not identified as
such because of an error in the laboratory. We estimated that 15 to 42
percent of window-period donations were discarded because they were
seropositive on laboratory tests other than the HIV-antibody test. When
these results were extrapolated to include the additional 23 Red Cross
service regions, there was a risk of one case of HIV transmission for
every 450,000 to 660,000 donations of screened blood. If the Red Cross
centers are assumed to be representative of all U.S. blood centers,
among the 12 million donations collected nationally each year an
estimated 18 to 27 infectious donations are available for transfusion.
CONCLUSIONS. The estimated risk of transmitting HIV by the transfusion
of screened blood is very small and nearly half that estimated
previously, primarily because the sensitivity of enzyme immunosorbent
assays has been improved.
DE Blood Banks Blood Donors Blood Transfusion/*ADVERSE EFFECTS/STATISTICS
& NUMER DATA Diagnostic Errors Disease Transmission,
Horizontal/*STATISTICS & NUMER DATA Enzyme-Linked Immunosorbent Assay
Human HIV Antibodies/BLOOD HIV
Infections/DIAGNOSIS/EPIDEMIOLOGY/*TRANSMISSION Incidence Risk United
States/EPIDEMIOLOGY JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).