The significance of the blood-borne viruses: blood banking and transfusion medicine.

Most of the blood-borne infections that have held our attention during the last half of this century have been well characterized. Although HIV and the hepatitis viruses have enormous world-wide public health implications, there has been considerable success in their prevention of transmission by transfusion. The technology is available to treat and eliminate from virtually all non-cellular blood products the transmission of disease caused by those viruses for which we have had the greatest concern. However, for the cellular blood products the basic methods of prevention continue to be imperfect: donor selection and viral serological testing. The significance of the transmission of blood-borne agents by these products depends upon the frequency of the agent in the donor population and the serological screening performed. There is a marked degree of variation in frequency of these infections, dependent upon geography, living conditions, and life style. Data on the frequency of transfusion-transmitted disease are meagre and usually based upon indirect estimates. In the United States the frequency of the transmission of HIV by cellular blood products is estimated to be 1:125,000 products transfused. A similar estimate for the transmission of hepatitis is 1:200 products transfused. For the developing countries, some of which experience the highest rates of hepatitis and HIV infection in their populations, data on the frequency of transfusion transmission are not generally available. In recent years, new evidence has stimulated interest in a few transfusion-transmissible diseases that, although uncommon from the public health perspective, have both real and potential transfusion impacts for the use of plasma and plasma derivatives as well as cellular products.(ABSTRACT TRUNCATED AT 250 WORDS)