Transmission of human immunodeficiency virus through bone transplantation: a case report

Human immunodeficiency virus (HIV) can be transmitted through tissue or organ transplantation. Since 1988, eight cases of bone transplantation-associated HIV infection have been reported. We describe a 34-year-old woman with osteoarthritis, who was hospitalized in 1996 because of painful locomotion and deformity in the right knee. An old fracture of the femur and genu varum in the right knee was repaired by open reduction and internal fixation, with allogeneic bone transplantation for defect reconstruction. Five months later, she presented at another hospital with pain and swelling of the right thigh, where screening for HIV was positive. The transmission was tracked to a 50-year-old man with no history of HIV screening, from whom the femoral head was procured when he underwent a hip replacement for left femoral neck fracture. This is the first reported case of HIV infection through bone transplantation in Taiwan, and the preventable nature of this transmission should be underscored.