       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).

