2008, Number 4
Next >>
Rev Invest Clin 2008; 60 (4)
HIV in Mexican blood donors and estimated transfusional risk
Arreguín V, Álvarez P, Simón JI, Valderrama JA, Macías AE
Language: Spanish
References: 29
Page: 278-283
PDF size: 59.76 Kb.
ABSTRACT
Objective. To determine the HIV seroprevalence in Mexican blood donors and the residual risk of transfusion.
Material and methods. The seroprevalence was determined in a sample of first-time blood donors at one hospital center in Mexico City, from 2003 to 2007. To estimate the seroprevalence reported in Mexican blood donors, we reviewed recent papers. To determine the positive likelihood ratio (LR+) of the EIA test the specificity was calculated against the western-blot result. To infer the residual risk, the incident infections were assumed to be 1.8 times more frequent for first-time donors.
Results. We analyzed 29,318 donors; 66 were reactive to HIV by EIA (225/100,000; 95% Confidence Interval: 171 to 279/100,000), but western-blot confirmed only 5 (prevalence = 17/100,000 donors; 95% CI: 2 to 32/100,000). The maximal residual risk was inferred to be 6.2 per million, or about 6.8 per year. The LR+ of the EIA test was calculated to be 476. The Bayesian analysis estimated that the disease is present in only 7.5% donors with a reactive EIA. Published reports in medical literature do not inform confirmatory tests for Mexican donors.
Discussion. The residual risk for HIV had been calculated to be about 100 per million of blood donors. Although we inferred that the risk had been overestimated by not performing confirmatory tests, the results are a call for action as the risk is still several times higher than the one reported in industrialized countries.
REFERENCES
Donegan E, Stuart M, Niland JC, Sacks HS, Azen SP, Dietrich SL, et al. Infection with human immunodeficiency virus type 1 (HIV-1) among recipients of antibody-positive blood donations. Ann Intern Med 1990; 113: 733-9.
Montagnier L. A history of HIV discovery. Science 2002; 298: 1727-8.
Villasís Keever A. A 20 años del descubrimiento del VIH. Rev Invest Clin 2003; 56: 122-3.
Carrillo-Maravilla E, Villegas-Jiménez A. El descubrimiento del VIH en los albores de la epidemia del SIDA. Rev Invest Clin 2004; 56: 130-3.
Córdova-Caballero S (ed.). Secretaría de Salud (México). Norma Oficial Mexicana (NOM-003-SSA2-1993) para la disposición de sangre humana y sus componentes con fines terapéuticos. México, D.F. Diario Oficial de la Federación 1994; 18: 61-92.
Sepúlveda Amor J, Del Río Zolezzi A, Valdespino GJL, García ML, Velázquez VL, Volkow P. La estrategia de prevención de la transmisión del VIH/SIDA a través de la sangre y sus derivados en México. Sal Púb Méx 1995; 37: 624-35.
Gutiérrez JP, López-Zaragoza JL, Valencia-Mendoza A, Pesqueira E, Ponce-de-León S, Bertozzi SM. Haciendo frente a la epidemia de VIH/SIDA en México: ¿Una respuesta organizada? Rev Invest Clin 2004; 54: 242-52.
Valdespino-Gómez JL, García-García ML, Del Río-Zolezzi A, Loo-Méndez E, Magis-Rodríguez C, Salcedo-Alvarez RA. Epidemiología del SIDA/VIH en México; de 1983 a marzo de 1995. Sal Pub Mex 1995; 37: 556-71.
Olivares-López F. SIDA asociado con transfusión de sangre. Sal Pub Mex 1993; 35: 351-6.
Vázquez-Flores JA, Valiente-Banuet L, Marín y López RA, Sánchez-Guerrero SA. La seguridad de las reservas sanguíneas en la República Mexicana durante los años 1999 a 2003. Rev Invest Clin 2006; 58: 101-8.
Huang LJ, Liu CY, Chu SC, Wong WW, Lin YC, Liu WT, et al. Predictive value of two commercial human immunodeficiency virus serological test in cases with indeterminate western blot results. J Microbiol Immunol Infect 2006; 39: 219-24.
Meles H, Wolday D, Fontanet A, Tsegaye A, Tilahun T, Aklilu M, et al. Indeterminate human immunodeficiency virus western blot profiles in Ethiopians with discordant screening-assay results. Clin Diagn Lab Immunol 2002; 9: 160-3.
Rivas-Llamas R. Frecuencia de serorreactividad al VIH en donadores de sangre de la ciudad de Culiacán, Sinaloa, México. Rev Biomed 1995; 6: 194-8.
Ayala GJJ, Guerra ÁFJ, Mora BP, Casillas RA. Prevalencia de marcadores virales para hepatitis B, C y virus de inmunodeficiencia humana en donadores de sangre voluntarios en el noreste de México. Rev Gastroenterol Mex 1997; 62: 250-3.
Pita-Ramírez L, Torres-Ortiz GE. Prevalencia de anticuerpos virales y reaginas luéticas en donadores de sangre de un hospital. Rev Invest Clin 1997; 49: 475-80.
Tristán Rojas CM, Nájera Robías E, Cázares Taméz R, Flores Aréchiga A. Estudio comparativo de la seroprevalencia observada en diferentes bancos de sangre de la República Mexicana. Rev Mex Patol Clin 1999; 46: 34-5.
Ramírez BJ, Muñoz-Valle JF, Navarro-Hernández RE. Frecuencia de anticuerpos contra el HIV, HCV y HBsAg en donadores familiares en el Hospital del Carmen de la ciudad de Guadalajara, Jalisco. Rev Mex Patol Clin 1999; 46: 243-8.
Borjas C, Carrero D, Rodríguez L. Prevalencia de los marcadores virales en donadores de sangre. Rev Biomédica 2001; 12: S66-S67.
Hernández-GCM, Varón-VE, Cuellar-Hinojosa N, Esquivel- RME, Quezada-MA. Serología de marcadores virales en donadores del banco de sangre del Hosp. Gral. Reg. No. 45 I.M.S.S. Guadalajara, Jal. Rev Biomédica 2001; 12: S68.
Carreto-Vélez MA, Carrada-Bravo T, Martínez-Magdaleno A. Seroprevalencia de VHB, VHC y VIH en donadores de sangre en Irapuato, México. Sal Pub Mex 2002; 45(Suppl. 5): S690-S693.
Offergeld R, Faensen D, Ritter S, Hamouda O. Human immunodeficiency virus, hepatitis C and hepatitis B infections among blood donors in Germany 2000-2002: risk of virus transmission and the impact of nucleic acid amplification testing. Euro Surveill 2005; 10: 8-11.
Renzullo PO, McNeil JG, Wann ZF, Burke DS, Brundage JF, United States Military Medical Consortium for Applied Retroviral Research. Human immunodeficiency virus type-1 seroconversion trends among young adults serving in the United States Army, 1985-1993. J Acquir Immune Defic Syndr 1995; 10: 177-85.
Sánchez-Guerrero SA, Romero-Estrella S, Rodríguez-Ruiz A, Infante-Ramírez L, Gómez A, Villanueva-Vidales E, et al. Detection of West Nile virus in the Mexican blood supply. Transfusion 2006; 46: 111-7.
Schreiber GB, Busch MP, Kleinman SH, Korelitz JJ. The risk of transfusion-transmitted viral infections. N Engl J Med 1996; 334: 1685-90.
Cumming PD, Wallace EL, Schorr JB, Dodd RY. Exposure of patients to human immunodeficiency virus through the transfusion of blood components that test antibody-negative. N Engl J Med 1989; 321: 941-6.
Jackson JB, MacDonald KL, Cadwell J, Sullivan C, Kline WE, Hanson M, et al. Absence of HIV infection in blood donors with indeterminate western blot tests for antibody to HIV-1. N Engl J Med 1990; 322: 217-22.
Busch MP, Kleinman SH, Williams AE, Smith JW, Ownby HE, Laycock ME, et al. Frequency of human immunodeficiency virus (HIV) infection among contemporary anti-HIV-1 and anti-HIV-1/2 supplemental test-indeterminate blood donors. The Retrovirus Epidemiology Donor Study. Transfusion 1996; 36: 37-44.
Lackritz EM, Satten GA, Aberle-Grasse J, Dodd RY, Raimondi VP, Janssen RS, et al. Estimated risk of transmission of the human immunodeficiency virus by screened blood in the united states. N Engl J Med 1995; 333: 1721-5.
Bakdash S, Yazer MH. What every physician should know about transfusion reactions. CMAJ 2007; 177: 141-6.