The U.S. blood supply is the safest in the world, and is now safer than it has ever been, according to many experts. In addition, the incidence of viral infections passed from blood donor to recipient has decreased, which suggests that the screening for disease that donors must go through is an effective way to prevent transmission of these infections.
Two articles and an editorial in the July 12 issue of The Journal of the American Medical Association examine the risk of infection in people who receive blood or blood products.
In the first, lead author Ai Ee Ling, MD, and colleagues examine a case of HIV transmission from an infected donor to two recipients of the infected blood. This happened in Japan when a donor gave blood after he was already infected but before it showed up in standard blood tests. Two individuals who received parts of this subject's blood became infected with HIV.
Experts have long been aware of this period during which tests for detecting HIV virus can turn up negative, says study co-author Mary E. Chamberland, MD. "This report is about a very rare situation, and one that we've known about. The window period is something that we've all been aware of since the very first tests were introduced for HIV and hepatitis C to screen blood donations."
In a second article, lead author Simone A. Glynn, MD, MSc, and colleagues report that they found the number of first-time blood donors infected with HIV or hepatitis C decreased significantly from 1991 to 1996.
"There is a potentially critical shortage of blood in the U.S.," Glynn advises potential donors. "Blood saves lives and is urgently needed. Safe repeat donors are essential to maintaining an adequate blood supply." She recommends that those who donate blood answer all screening questions honestly, and refrain from donating blood if they have any known risk factors for viral infections that could be transmitted through blood.
The overriding message here is that blood transfusion in the U.S. is very safe. Still, for those people who may be concerned about the tiny risk of receiving blood from someone infected with HIV or hepatitis C, there are options such as "autologous donation," in which you donate your own blood to yourself, notes Chamberland.
"If surgery is planned, and there is an anticipated need for blood or blood products, patients should talk to their physicians in advance. Autologous donation is a possibility. Using your own blood offers a lot of other pluses besides avoiding infectious diseases," she says.
Also, patients need to discuss the risks and benefits of receiving blood with their physician, and "should feel secure in knowing that our blood supply is extraordinarily safe and these are very rare events," says Chamberland, who is assistant director of blood safety in the division of viral and rickettsial diseases at the CDC in Atlanta.
"The U.S. blood supply is among the safest in the world. It's far safer today than at any other time in history," she adds.
Indeed, notes Harvey G. Klein, MD, in his accompanying editorial, not only is the blood supply in this country safe, but it is less risky than many of the other drugs and treatments patients are being given. "Blood is not entirely safe, but neither is it the most dangerous drug currently available. Like many good things, it comes with risks," he writes.