The role of commercial plasmapheresis banks on the AIDS epidemic in Mexico.
OBJECTIVE
To characterize the circumstances underlying the epidemic of AIDS associated with blood transfusion in Mexico and to explore the possible mechanisms for its dissemination.


METHODS
A retrospective analysis comparing the total number of AIDS cases and transfusion-associated AIDS cases and the male:female ratio reported in Mexico and the U.S. from 1981 to 1996 was done. We analyzed the relationship between the location of plasmapheresis banks and the geographic distribution of transfusion-associated AIDS cases and AIDS cases among paid donors in order to assess the possible role of plasmapheresis banks in its dissemination.


RESULTS
The proportion of transfusion-associated AIDS in the total number of cases was significantly higher in Mexico than in the U.S. from 1987 through 1996 (p < .0001). A rapid drop in the male:female ratio of AIDS was observed in Mexico but not in the U.S. coinciding with a growing number of transfusion associated cases; transfusion has been the main risk factor for AIDS in women in our country. In 1986, seven States and Mexico City had plasmapheresis banks: they reported 90% of the cases associated to paid donation and 75% of those associated to transfusion, despite the fact that commercial blood banks without plasmapheresis facilities existed in 23 of the other 24 States.


CONCLUSIONS
There was a difference on the frequency of transfusion associated AIDS between Mexico and the U.S. which reached epidemic proportions in Mexico. We believe that plasmapheresis banks played a major role in the dissemination of the infection in Mexico as paid donors provided a third of the blood used in Mexico in 1986. These findings highlight important implications for the prevention of AIDS in developing countries where commercial plasmapheresis practices are still in operation.
Volkow
P
P
Instituto Nacional de Cancerología, Department of Infectious Diseases, México D.F.
Perez-Padilla
R
R
del-Rio
C
C
Mohar
A
A
D000163:Acquired Immunodeficiency Syndrome / Q000209:etiology*; D001771:Blood Banks / Q000191:economics / Q000592:standards; D001782:Blood Donors; D004196:Disease Outbreaks; D005260:Female; D015658:HIV Infections / Q000517:prevention & control; D006679:HIV Seropositivity; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D010956:Plasmapheresis / Q000009:adverse effects* / Q000592:standards; D065227:Transfusion Reaction; D014481:United States / Q000453:epidemiology