Blood/Tissue/Organ Supply

Pages25-27

Page 25

The Issue

HIV infection can be spread through blood products, and shared human tissue and organs. The risk of infection by a transfusion of HIV-contaminated blood exceeds 90 percent. Early in the epidemic many people were infected through blood transfusions and organ or tissue donation. Once diagnostic tests were developed to detect HIV in blood and other bodily products, most countries quickly enacted laws and regulations to require screening of all blood, tissue, and organs to be used for donation in humans. Many of these laws also provide for the sanitary disposal of any sample found to be HIV-positive. Overall, these efforts have protected most transfusion and transplant recipients from receiving contaminated blood, tissue, and organ products, resulting in a substantial reduction in the incidence of HIV transmission through these products.

Legal and Policy Considerations

While it is mandatory to screen blood, tissue, and organ products for HIV around the globe, there is some variation in how this screening is done. In many places, the testing is done universally and anonymously-blood or tissues found to be infected are removed from distribution and destroyed, but the donors are not notified of their infection. Other countries have implemented systems that enable the donor to be contacted with their test results. Some countries have enforced laws that require health care professionals to suggest to those who are HIV infected that they refrain from donating blood, tissue, or organs. Additionally, some countries permit transfusion and transplantation recipients to demand a second HIV test of blood, tissue, or organ products prior to receiving them.

UNAIDS and IPU identify two vital elements for safe blood supply aside from screening blood for HIV. First, countries should have a national, nonprofit blood transfusion service that is accountable to the government. Namibia, South Africa, Zambia, and Zimbabwe, among others, all have implemented such systems. Second, blood transfusion services should take blood from voluntary donors with a low risk of infection and avoid paid or professional donors whenever possible. In Cambodia, for example, the International Committee of the Red Cross photographs blood donors who are regularly present at blood donation centers and refuses to take their blood if they are seen too often.

In several highly...

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