HIV1/HIV2 and transfusion
Reviewer: Huy Phu Pham, M.D. (see Reviewers page)
Revised: 16 November 2011, last major update October 2011
Copyright: (c) 2007-2011, PathologyOutlines.com, Inc.
● HIV is a lentivirus, a subgroup of the retrovirus family
● HIV is transmitted through sexual contact, childbirth, breast-feeding, and parenteral exposure to blood
● HIV transmission by blood products is efficient: infectivity is 90-100% for contaminated blood versus 0-2% for needlestick injuries (AIDS 2006;20:805)
● Transfusion associated HIV cases usually have an acute viral syndrome; if untreated, progress to AIDS in 10 years
● HIV1 and HIV2 both can cause AIDS; HIV2 is rare in US, with NO reported cases of transfusion transmission in US
● Possibility of transfusion associated HIV is frightening to many patients, but actual risk is only 1 per 2 million products tested for HIV1 and about 1 per 5-8 million products transfused in US
● Pathogen inactivation has eliminated transmission in US licensed plasma derivatives since 1985; however technique cannot be used for cellular components (Arch Pathol Lab Med 2007;131:719)
● Identification of recipients of products from HIV+ donors is mandated by FDA
● Risk in France is 1 per 3 million (Euro Surveill 2005;10:5), in Ivory Coast is 1 per 6,000 (Transfus Clin Biol 2006;13:242)
● Current standard is serologic antibody testing (1 per 33K positive) plus nucleic acid testing (reduces window of seronegativity between time of infection and development of antibodies, Transfus Med 2007;17:200)
● Risk exists for blood donated through window of seronegativity, and 4 “breakthrough” cases have been identified (nonreactive by nucleic acid testing - Vox Sang 2004;86:171, Transfusion 2004;44:929)
● Most transfusion medicine litigation focuses on transfusion acquired HIV (Arch Pathol Lab Med 2007;131:615)
End of Transfusion Medicine > Tranfusion-transmitted disease > HIV1/HIV2 and transfusion
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