Transfusion Related Transmission of Infectious Disease



- See: Blood Prod Menu

- Discussion:
    - septic reaction: considered when high fever and hypotension accompany a transfusion reaction;
    - transmission of disease:
            - HIV: risk is estimated to be about 1 in 200,000-800,000;
            - hepatitis B: estimated risk is 1 in 200,000;
            - hepatitis C:
                   - probably 2-3% of population has hepatitis C antibodies, and hepatitis C related cirrhosis is the leading cause of liver transplantation in the US;
                   - now that 2nd generation screening tests are available, estimated transfusion risk is 1 in 3,000-5,000 (but may be as low as 1:100,000);
                   - infection tends to be chronic and perisistent eventhough patients may be asymptomatic - long term, cirrhosis may develop in 20%;
                   - clincical findings: ascites, heptosplenomegaly, and encephalopathy;
                   - lab test will reveal elevated LFT's (ALT), and liver biopsy may reveal portal or bridging fibrosis,
                          and at least moderate degrees  of inflammation and necrosis;
                   - be aware that combination of interferon and ribavirin has been FDA approved for treatment of hepatitis C;
                          - w/ needle stick injury, consider inteferon treatment (50 % effective);
                          - w/ no treatment, risk of infection is about 3.5%;
                   - patients need to avoid contaminating family members avoid sharing utensiles, toothbrushes ect;
                   - references:
                          - Hepatitis C Virus Infection:  Review and Implications for the Orthopaedic Surgeon
                          - Incidence of hepatitis C in patients requiring orthopaedic surgery.
                          - The declining risk of post-transfusion hepatitis C virus infection.



Medical News & Perspectives: As the Blood Supply Gets Safer, Experts Still Call for Ways to Reduce the Need for Transfusions.




Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Wednesday, April 11, 2012 3:03 pm