Risk of HIV infection from transfusion with blood negative for HIV antibody in a west African city.
OBJECTIVE
To estimate the risk of infection with HIV (HIV 1 or HIV 2, or both) from transfusion of a screened unit of blood in a high prevalence area in west Africa.


METHODS
Retrospective cohort study for January-July 1991.


METHODS
National Blood Transfusion Centre, Abidjan, Côte d'Ivoire.


METHODS
Repeat donors (5831 units of blood) and first time donors (5076 units) in the first five months of 1991.


METHODS
Prevalence and estimated incidence of HIV infection in repeat and first time donors; estimated rate of potentially infected, HIV antibody negative units; and rate of (false negative) potentially infected units assuming a laboratory test sensitivity of 99%.


RESULTS
Overall HIV prevalence was 11.0% in first time donors and 2.1% in repeat donors. In the first seven months of 1991, 29 HIV antibody positive (27 HIV 1, 1 HIV 2, 1 dually reactive) donors with a seronegative unit of blood earlier in the year were identified; 26 had donated blood eight weeks or less before their estimated dates of seroconversion and may have been infectious (minimum rate 26/5831 (4.5/1000 potentially infected units)). Estimated incidence of infection in repeat donors was 1.2-2.5%. Laboratory test insensitivity would result in an estimated 1.1/1000 false negative units from first time donors and 0.2/1000 units from regular donors. The overall rate of potentially infected units (all donors, seroconversions, and errors) was estimated at 5.4-10.6/1000.


CONCLUSIONS
The risk of HIV infection from a single unit of blood remains substantial (5.4-10.6/1000 units). To prevent infection from blood transfusion in areas of high incidence and prevalence of HIV all but absolutely essential transfusions should be avoided, and donors with low incidence of HIV infection should be selected.
Savarit
D
D
Centre National de Transfusion Sanguine, Abidjan, Côte d'Ivoire.
De Cock
K M
KM
Schutz
R
R
Konate
S
S
Lackritz
E
E
Bondurand
A
A
D001782:Blood Donors; D015331:Cohort Studies; D007560:Cote d'Ivoire / Q000453:epidemiology; D015483:HIV Antibodies / Q000032:analysis*; D015658:HIV Infections / Q000097:blood / Q000453:epidemiology / Q000635:transmission*; D006679:HIV Seropositivity; D015497:HIV-1 / Q000276:immunology*; D015498:HIV-2 / Q000276:immunology*; D006801:Humans; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D065227:Transfusion Reaction
D015483:HIV Antibodies