Blood issues update: minimizing the risk of transfusion-associated HIV infection. American Hospital Association...

In March 1987, the Centers for Disease Control (CDC) (Atlanta), identified individuals who received multiple transfusions collected in high risk areas before April 1985 (when a blood screening test became available) as a group at risk for acquired immunodeficiency syndrome (AIDS). The exact number of individuals in this risk group is unknown but thought to be small. Nevertheless, this problem has attracted the attention of the President's Commission on the HIV Epidemic which, in its final report, issued June 24, 1988, recommended notification of every patient who received a blood transfusion since 1977 of their potential exposure to human immunodeficiency virus (HIV). The White House response to the report appeared to support the recommendation, as did the subsequently dropped William Dannemeyer amendment to the Waxman AIDS Testing/Confidentially Bill (HR 4757). In addition, some hospitals in high risk areas implemented such programs on their own initiative. To date there is no regulatory requirement for hospitals to notify past blood recipients. Unknowing transmission of pre-HIV test transfusion-related AIDS is a public health issue that in most cases is best assessed and resolved on an individual basis by patients and their physicians. The purpose of this communication is to inform hospitals about the existence of the risk group, to provide historical perspective on the issue, and to suggest ways in which hospitals can cooperate with and support medical staff in routinizing protection of this risk group and their contacts.