title: Human immunodeficiency virus type 1 activation after blood transfusion.
abstract: BACKGROUND
  Anemia and transfusion are predictors of disease progression in AIDS patients. This study was designed to examine the effects of blood transfusion on human immunodeficiency virus type 1 (HIV-1) expression.
  
  
  METHODS
  Assays of plasma viral load were performed before and after transfusion in nine HIV-1-infected patients who required blood transfusion for refractory anemia.
  
  
  RESULTS
  There was a modest rise in plasma HIV-1 p24 antigen and plasma HIV-1 RNA beginning 1 to 2 weeks after the blood transfusion. The mean change in plasma p24 antigen for all patients was 9.3 +/- 5.1 (mean +/- SE) pg per mL at Week 2 after transfusion and 18 +/- 11.1 pg per mL at Week 4. Plasma HIV-1 RNA levels were unchanged immediately after transfusion and exceeded pretransfusion levels with a mean rise of 84 +/- 40 percent (SE) at Week 1, 70 +/- 27 percent at Week 2, and 67 +/- 38 percent at Week 4 (p = 0.006, exact permutation test). There was no increase in spontaneous or interleukin 2-induced lymphocyte proliferation or p24 antigen production by patients' lymphocytes that were examined immediately after blood transfusion.
  
  
  CONCLUSIONS
  The transfusion of blood to persons with advanced HIV-1 infection modestly increases plasma levels of HIV-1. The activation of HIV-1 expression by transfusion may help to explain the accelerated course of HIV-1 disease in recipients of blood transfusion.
authors.affiliation: Department of Medicine, Case Western Reserve University, University Hospitals of Cleveland, Ohio, USA.
authors.forename: P M
authors.initials: PM
authors.lastname: Mudido
authors.forename: D
authors.initials: D
authors.lastname: Georges
authors.forename: D
authors.initials: D
authors.lastname: Dorazio
authors.forename: B
authors.initials: B
authors.lastname: Yen-Lieberman
authors.forename: S
authors.initials: S
authors.lastname: Bae
authors.forename: W A
authors.initials: WA
authors.lastname: O'Brien
authors.forename: J
authors.initials: J
authors.lastname: Spritzler
authors.forename: M M
authors.initials: MM
authors.lastname: Lederman
mesh_terms: D000740:Anemia / Q000209:etiology / Q000628:therapy*; D015658:HIV Infections / Q000150:complications / Q000628:therapy* / Q000821:virology; D015497:HIV-1 / Q000254:growth & development*; D006801:Humans; D065227:Transfusion Reaction; D019562:Viral Load; D014775:Virus Activation