HIV Testing

[Wendy Beltrami]

Double posted on Aplastic Central site:

Hi Gang,
Do any of you that are transfusion dependent get tested regularly for HIV?
It has suddenly occurred to me (duh!) that this is something we should be doing.
Yes, I'm scaring myself half to death as we are still trying to track down the cause of Grant's ongoing skin/scalp issues.

Just wondering...

I read that the risk is one per million. Of course with every transfusion that risk goes up. I did also read that the risk is greater with whole blood (which we never get) vs. the individual products (platelets, prbcs, etc.)

Does anyone know whether irradiating helps reduce the risk? I don't think this topic has ever been discussed on this forum and it surprises me. Are we all just whistling in the dark?

Wendy/mom to Grant

[Neil Cuadra]

Good questions, Wendy. The last thing patients need is to become infected from a blood transfusion, but the possibility is real, if small. I wonder what each of our doctors would say about the idea of getting tested, if not regularly, at least occasionally.

For those who are interested, here is some background information about blood safety:

HIV and other viruses have incubation times during which they aren't detected by tests of donated blood. The Red Cross has tested for the HIV-antibody since 1985 and the HIV antigen since 1996, as part of the blood screening it does.

Potential blood donors are interviewed to try to screen out donors likely to have diseases that may not be detectable. Donors are given multiple confidential ways to opt-out from having their blood used, both before and after making a donation.

That leaves a small risk of getting HIV-infected blood from a transfusion. How small? As of last year, the American Association of Blood Banks (AABB) puts the odds of HIV infection from a one-unit transfusion at between 1 in 450,000 and 1 in 676,000. For comparison, the risk of hepatitis B is 1 in 63,000 and the risk of hepatitis C is 1 in 103,000, i.e., 5 to 10 times more likely. See Infectious Risks.

Tests performed on donated blood continue to improve. Nucleic acid amplification testing (NAT) has been in use in the U.S. since 1999 and has further decreased the chances of HIV in the blood supply.

Interviews also help screen for risk of "mad cow disease" (bovine spongiform encephalopathy, or BSE) and the related disease vCJD (variant Creutzfeldt-Jakob disease). See the Red Cross Mad Cow Disease FAQ.

To Wendy's questions we can add another question: Do our hospitals use donor screening and blood tests similar to those the Red Cross uses?

[Wendy Beltrami]

Neil-

Thanks for those statistics.

I mentioned in an earlier post that after last year's conference, I corresponded with Marilyn a bit about having someone from Red Cross or some other blood bank organization come and speak at the conference. This is a clip from my email:

<Wouldn't it be interesting to have a representative/speaker from a blood bank next year to share information about blood collection, bacteria screening, irradiation, single donor platelets, hospital protocols, transfusing out of type platelets (pros and cons), etc.>

Now, I'm thinking that adding info about HIV and Hep B & C risks and screening might also be useful.

I don't see anything mentioned on the conference agenda so I'm assuming this topic died somewhere along the line!?

Wendy B.
mom to Grant

[Neil Cuadra]

It's not on the agenda for this year's conference, but please submit that suggestion again. I too think it would be helpful to hear from somebody with knowledge of these details.

This year, in addition to the usual Q&A time we get after the conference speakers make their presentations, there will be 2 hours of "roundtable discussions" (more question-and-answer time) with individual doctors, in separate rooms. The doctors can probably address the medical side of these blood usage questions, but it would be helpful to have blood bank representatives to tell us about protocols, screening techniques, etc.