INFECTION WITH HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 (HIV-1) AMONG RECIPIENTS OF ANTIBODY-POSITIVE BLOOD DONATIONS
INFECTION WITH HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 (HIV-1) AMONG RECIPIENTS OF ANTIBODY-POSITIVE BLOOD DONATIONS
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DOI：
10.7326/0003-4819-113-10-733
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发表时间：
1990-11-15
影响因子：
39.2
通讯作者：
MOSLEY, JW
中科院分区：
文献类型：
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作者：
DONEGAN, E;STUART, M;MOSLEY, JW
目的：评估人类免疫缺陷病毒1型(HV-1)通过抗HIV-1阳性血液成分传播的发生率，并确定HIV-1感染受者的免疫学和临床过程。设计和对象：我们对1984年末和1985年储存的大约200,000份献血者血液成分样本进行了回顾性检测，并联系了阳性样本的接受者，以确定他们的血清学状态。他们与接受HIV-1阴性输血的人和健康(未输血)的对照组进行了比较。受试者每隔3-6个月接受一次长达4年的临床和免疫学评估。测量和主要结果：在133名受试者中，9人有其他可能的接触。排除这些病例，124例中有111例(89.5%)抗-HIV-1阳性(95%可信区间为84.1%-94.5%)。受者“S”的性别、年龄、基础条件和器官类型不影响感染率。输血后38个月内发生获得性免疫缺陷综合征(AIDS)的累积风险为13%(CI，7.5%至21.6%)。36。+-。指标输血3个月后，血清阳性受者的CD2+CDw26+、CD4+、CD4+CD29+和CD4+CD45RA+亚群数量低于抗HIV-1阴性受者，CD8+12+淋巴细胞数高于抗HIV-1阴性受者。CD_4~+和CD_2~+CDw26~+亚群变化最快。CD8+绝对计数保持正常。结论：输血抗HIV-1阳性血的受者感染率为90%。在感染后的头38个月内发展为艾滋病的比率与同性恋男子和血友病患者的报告相似。虽然大多数淋巴细胞亚群计数随着时间的推移而变化，但CD8+计数是恒定的。
Objective: To assess the incidence of human immunodeficiency virus type 1 (HV-1) transmission by antibody (anti-HIV-1)-positive blood components, and to determine the immunologic and clinical course in HIV-1-infected recipients. Design and Subjects: We retrospectively tested approximately 200,000 donor blood component specimens stored in late 1984 and 1985 for anti-HIV-1, and we contacted recipients of positive specimens to determine their serologic status. They were compared with both recipients of HIV-1-negative transfusions and healthy (untransfused) controls. Subjects were seen at 3- to 6 month intervals for up to 4 years for clinical and immunologic evaluations. Measurements and Main Results: Of 133 recipients, 9 had other possible exposures. Excluding these cases, 111 of 124 (89.5%) were anti-HIV-1-positive (95% CI, 84.1% to 94.5%). The recipient''s sex, age, underlying condition, and type of component did not influence infection rates. The cumulative risk for developing the acquired immunodeficiency syndrome (AIDS) within 38 months after transfusion was 13% (CI, 7.5% to 21.6%). At 36 .+-. 3 months after the index transfusion, seropositive recipients had lower counts of CD2+CDw26+, CD4+, CD4+CD29+, and CD4+CD45RA+ subsets and more CD8+12+ lymphocytes than did recipients of anti-HIV-1-negative transfusions. The CD4+ and CD2+CDw26+ subsets changed the most rapidly. The absolute CD8+ count remained normal. Conclusions: Transfusion of anti-HIV-1-positive blood infected 90% of recipients. The rate of progression to AIDS within the first 38 months after infection was similar to that reported for homosexual men and hemophiliacs. Although most lymphocyte subset counts changed over time, CD8+ counts were constant.