From the Guidelines
The risk of contracting HIV from a blood transfusion is approximately 1 in 1,467,000 transfused blood components, as estimated by recent studies 1. This remarkably low risk is due to rigorous screening protocols implemented by blood banks, including comprehensive donor questionnaires to identify high-risk individuals, and advanced laboratory testing of all donated blood for HIV antibodies and viral RNA. The testing process now includes nucleic acid testing (NAT), which can detect HIV infection during the "window period" when antibody tests might still be negative. Some key points to consider include:
- The residual risk of HIV transmission through blood transfusion has been significantly reduced since the implementation of screening measures in the mid-1980s 1.
- The estimated residual risk for HIV is 6.8 per 10 million transfused components, as reported in a study published in the Annals of Internal Medicine 1.
- Patients requiring transfusions should understand that the life-saving benefits of receiving needed blood products far outweigh the minimal risk of HIV transmission in settings with modern blood banking practices.
- In developing countries with less robust screening systems, the risk may be higher, highlighting the importance of stringent blood screening protocols to minimize the risk of HIV transmission through blood transfusion 1.
From the Research
Risk of Contracting HIV from Blood Transfusion
- The risk of HIV transmission through blood transfusion has decreased significantly in industrialized countries due to the use of sensitive HIV screening tests, donor deferral, and conservative use of blood 2.
- In the USA, the risk of HIV transmission from blood screened negative for HIV antibody is estimated to be one in 440,000-660,000 donations 2.
- However, in developing countries, the risk of HIV transmission through blood transfusion is much higher, with an estimated 5-10% of HIV infections attributed to blood transfusion 2.
- A study in Kenya found that 2.0% of transfusions transmitted HIV, primarily due to erroneous laboratory practices 3.
- The implementation of HIV blood screening programs, such as those supported by PEPFAR, has been shown to reduce the risk of HIV transmission through blood transfusions in developing countries 4.
Factors Contributing to HIV Transmission through Blood Transfusion
- Inconsistent refrigeration, data entry errors, equipment failure, and lack of quality-assurance programs can contribute to the risk of HIV transmission through blood transfusion 3.
- The prevalence of HIV among blood donors is a significant factor, with higher prevalence rates in developing countries 2, 3.
- The use of sensitive HIV screening tests, such as genome amplification techniques and HIV-1 p24 antigen testing, can help reduce the risk of HIV transmission through blood transfusion 2.
Prevention and Management of HIV Transmission through Blood Transfusion
- The use of post-exposure prophylaxis (PEP) can help prevent HIV transmission after occupational exposure to HIV 5, 6.
- PEP regimens should be started as soon as possible after exposure and continued for a 4-week duration 6.
- Expert consultation and close follow-up are recommended for individuals who have been exposed to HIV through blood transfusion 6.