The HIV information project for transfusion recipients a decade after transfusion
S. M. King, T. Murphy, M. Corey, A. M. Newman, C. Major, B. W. McCrindle, J. Irwin, M. Stevens, M. Fearon and A. O. Poon
Division of Infectious Diseases, Hospital for Sick Children, University of Toronto, Ontario.
OBJECTIVE: To gather information on which to base decisions about a general
notification program for pediatric patients a decade after their receiving
transfusions. DESIGN: The physicians of a cohort of 1793 patients who
underwent cardiac surgery were sent letters asking them to contact and
counsel patients identified from cardiovascular surgery and blood bank
databases about their risk for human immunodeficiency virus (HIV)
infection. Questionnaires were used to collect data about physicians' HIV
practices; telephone interviews were conducted to collect information about
patients' and parents' knowledge and attitudes about HIV and transfusions.
Because of unexpected media interest, questionnaires and interviews were
modified to include questions about the source of information. The
HIV-testing status of patients reported by physicians was anonymously
cross-referenced with specimens received by the Laboratory Services Branch,
Ontario Ministry of Health, Toronto. SETTING: A large Canadian pediatric
tertiary care hospital in Toronto. PARTICIPANTS: Seven hundred ninety-three
patients undergoing cardiopulmonary bypass between 1980 and 1985. RESULTS:
The HIV Information Project successfully reached most (approximately 75%)
of this cohort and, with the help of the media, many other at-risk
transfusion recipients. The information was new for many; almost all
informed wanted to undergo testing. The seroprevalence of this group that
received multiple transfusions was, at minimum, 8.5 patients in 1000. Six
previously unsuspected HIV-seropositive cases were diagnosed. CONCLUSIONS:
Although we had assumed that most patients receiving transfusions would be
aware of their risk for HIV infection, our results indicate that, even a
decade after the transfusion, many recipients were not aware of the risk
and wanted to undergo testing. Testing identified asymptomatic infected
patients.
