Thursday, May 19, 2022

Why Do Hiv Patients Need Blood Transfusions

Are There Risks In Receiving Designated Donor Or Allogenic Blood

Blood transfusion | Health | Biology | FuseSchool

All donors are screened and donor blood is tested, but there are still risks with any transfusion. The following are odds of infection from studies published in 1996:

  • Infection with the AIDS virus: 1 in 675,000 transfusions
  • Infection with HTLV: 1 in 640,000 transfusions
  • Infection with Hepatitis B virus: 1 in 63,000 transfusions
  • Infection with Hepatitis C virus: 1 in 100,000 transfusions

Other possible adverse reactions to a blood product include Graft versus Host Disease . GVHD is a potentially life-threatening reaction from transfusion between blood relatives. Irradiation of the donated blood prevents this occurence, and is performed on all units of designated donor blood from blood relatives.

Severe allergic reaction to a blood product affects about 1 in 100,000 transfusions. Most allergic reactions are mild and cause a slight fever or rash.

As a precaution, women who may become pregnant should not receive a designated donation from their husband or partner, as it may be harmful to future children.

Who Needs A Transfusion

Blood transfusions are very common. Each year, almost 5 million Americans need blood transfusions. This procedure is used for people of all ages.

Many people who have surgery need blood transfusions because they lose blood during the operation. For example, about one-third of all heart surgery patients have a transfusion.

Some people who have serious injuries such as from car wrecks, war, or natural disasters need blood transfusions to replace blood lost during the injury.

Some people need blood or parts of the blood because of illnesses. You may need a blood transfusion if you have:

  • A severe infection or liver disease that stops your body from properly making blood or some parts of blood.
  • An illness that causes anemia, such as kidney disease or cancer. Medicines or radiation used to treat a medical condition also can cause anemia. There are many different types of anemia, including aplastic, Fanconi, hemolytic, iron-deficiency, and sickle cell anemias and thalassemia.
  • A bleeding disorder, such as hemophilia or thrombocytopenia.
  • Hepatitis A And E Viruses

    The hepatitis A virus is a single-stranded RNA enterovirus and a member of the Picornaviridae family. In humans, viral replication depends on hepatocyte uptake and synthesis, and assembly occurs exclusively in liver cells. The common method of HAV transmission is via the fecal-oral route, but the infection may also rarely be transmitted through blood transfusion.

    The hepatitis E virus is classified in the Caliciviridae family and has many similarities with HAV. The common mode of transmission is also fecal-oral, but HEV may also be transfusion transmitted. HEV can occur with transfusion of RBCs, platelet concentrate, fresh frozen plasma, and pooled granulocytes.

    Both of these nonenveloped viruses are not inactivated by the methods used in the production of blood components subjected to plasma fractionation and processed by solvent and detergent methods alone.

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    How Should We Prepare For A Blood Transfusion

    If your child needs a blood transfusion, the doctor will describe the procedure. Parents should ask questions if the explanation isn’t clear. A parent or legal guardian will need to sign an informed consent form. This states that you understand the procedure and its risks, and give your permission for your child to have it.

    If the situation is not a life-threatening emergency, two important tests will be done before the transfusion:

    1. Blood typing. To confirm your child’s blood type, a nurse or technician will draw a sample from a vein in your child’s arm. This blood is immediately labeled with your child’s name, birth date, and medical record number, and an armband with matching information is made for your child to wear. The blood is then sent to the hospital’s blood bank lab, where technicians test it for blood type.

    The 4 types of blood are:

    • type A
    • type AB

    Each blood type also can be positive or negative.

    2. Cross-matching. After blood typing is complete, a compatible donor blood is chosen. As a final check, a blood bank technologist will mix a small sample of your child’s blood with a small sample of the donor blood to confirm they are compatible. Then the blood is labeled with your child’s name, birth date, and medical record number and taken to where your child will get the transfusion.

    Can Blood Transfusions Cure Hiv

    Lifeblood

    Welcome to our science-like weekly feature, “Hey, Science,” in which we will have our most provocative scientific questions answered by real live scientists . No question is too smart for us to tackle, theoretically speaking. This week, experts address a Gawker reader’s wacky theory: Can massive blood transfusions be used to treat AIDS?

    THE QUESTION: This question comes from inquisitive reader Michael, who asks, “Could you cure, or at a minimum delay the effects of, the AIDS virus by simultaneously drawing infected blood and transfusing in ‘clean’ blood into the patient? You would still have tainted blood in the system, but wouldn’t this turn the clock back a bit in regard to how much of the virus is in the person’s blood stream?” What say you, doctors√Ęcan EXTREME blood transfusions fix HIV?

    Dinesh Rao, assistant professor, David Geffen School of Medicine at UCLA:

    Not a bad question actually. The issue is that the virus infects T cells and these reside both in the blood and in tissues, such as the lymph nodes and the gastrointestinal tract. So even if one were to entirely rid the blood of the virus , there would be other sites such as those I mention that would still have “reservoirs” of virus. Add to this the difficulty and potential complications of doing the blood exchange, which is done for certain other conditions… And you have a sufficiently bad benefit/harm ratio to make the procedure untenable.

    Michael Poles, associate professor, NYU School of Medicine:

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    Protecting Hospital Workers From Hiv

    If a hospital worker has an accident involving your blood, you may be asked to allow the hospital to test your blood for HIV, hepatitis C and hepatitis B.

    PEP is the use of antiretroviral drugs to prevent HIV following a high-risk exposure. Ideally, PEP is commenced within 72 hours of an exposure. PEP has been shown to significantly reduce the risk of HIV infection following exposures to HIV.

    In such circumstances, if you were unaware of your status and your blood tested positive for HIV, hepatitis B or hepatitis C, it would also enable you to access the appropriate treatment for your condition.

    There are new drugs available for treatment of hepatitis C that result in cure of that infection. Both hepatitis B and HIV have treatments available that can keep people with these infections well.

    Where Does The Blood For A Transfusion Comes From

    Because there’s no substitute for blood, the blood supply used for transfusion must be donated. The three types of blood donation are:

    Autologous blood donation. This is when someone donates their own blood ahead of time for a planned surgery or other procedure. There is no age requirement, but in general, kids don’t donate their blood for their own use until they’re over age 12.

    Directed donation. This is when a family member or friend with a compatible blood type donates blood specifically for use by a patient in need of transfusion.

    Volunteer donation. There’s no medical proof that blood from directed donors is any safer than blood from volunteer donors. So most patients receive blood donated through blood drives. These are often run by agencies like the American Red Cross. The minimum age for donating blood is 16 or 17 years old, depending on where a person lives.

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    Microbiologic Spectrum Of Transfusion

    A multitude of microorganisms have been isolated from contaminated blood products. There is also a wide variation in the species of bacteria that are reported from different parts of the world. Some of these organisms and species include the following:

    • The Bacthem study, BaCon study, and SHOT program found a similar range of microorganisms isolates from the Bacthem study included Yersinia, Proteus, Pseudomonas, Escherichia, Klebsiella, Acinetobacter, and Serratia, while among gram-positive organisms, Propionibacterium, Staphylococcus, Bacillus, and Enterococcus were isolated

    • The Japanese Red Cross reported Propionibacterium acnes as the most common bacterial contaminant

    • Blood banks in Holland reported coagulase-negative staphylococci to be the most common bacteria isolated

    • Some investigators have reported Yersinia enterocolitica as the most common isolate in TTBI this organism is capable of growing and multiplying at low temperatures, which may increase its chances of survival during storage of blood products

    What Is Blood Made Of

    Blood Transfusion Procedure Nursing | Reaction Types, Complications (Hemolytic/Febrile) NCLEX

    Blood is a mixture of cells and liquid, and each part has a specific job:

    • Red blood cells carry oxygen to the body’s tissues and remove carbon dioxide. These cells are the ones that are most commonly transfused.
    • White blood cells help the body fight infection by making antibodies, .
    • Platelets, the smallest blood cells, help to clot the blood and control bleeding.
    • Plasma, the pale yellow liquid part of whole blood, is a mixture of water, proteins, electrolytes, carbohydrates, cholesterol, hormones, and vitamins.

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    Can I Get Hiv From Donating Blood

    There is no chance of getting HIV from donating blood. New, disposable and sterile needles will be used to collect your blood.

    If you suspect that the needle your healthcare professional is using is not new or sterile then ask them to change the needle and check that it comes out of a sealed pack before agreeing to give blood.

    How Are Haemophilia And Hiv Connected

    During the late 1970s and early 1980s, haemophilia treatments were made from donated blood. Some of this blood came from people who had HIV or other blood-borne viruses, such as hepatitis C, so thousands of people with haemophilia were infected. This is often referred to as the blood scandal.

    Blood is now screened and factors are heat treated.

    Quote text

    In the 1970s and 1980s around 5,000 people with haemophilia and other bleeding disorders were multiply-infected with HIV, hepatitis B and C and a range of other blood-borne viruses. Over 2,400 people have since died and of the 1,200 people infected with HIV less than 250 are still alive.

    The All-Party Parliamentary Group on Haemophilia and Contaminated Blood reported on this group of people and their struggle to get help and compensation in January 2015.

    In 2018 a public inquiry began into the Contaminated Blood Scandal. It is believed to have included the largest number of participants of any UK public inquiry to date.

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    Human Immunodeficiency Virus Infection In Transfusion Recipientsand Their Family Members

    CDC has received a report of human immunodeficiency virus infection among multiply-transfused leukemia patients in New YorkCity. In addition, there have been several reports that persons withtransfusion-associated HIV infection have transmitted the virus totheir sexual partners and newborn children. All infected transfusionrecipients described in these reports had received blood or bloodcomponents before routine screening of donated blood for HIV antibodywas begun in the spring of 1985.Multiply-Transfused Leukemia Patients

    During the past year, four long-term leukemia survivors atMemorial Sloan-Kettering Cancer Center in New York City developedunexplained fever, weight loss, diarrhea, or lymphadenopathy. Theysubsequently had positive serological tests for HIV antibody. Aretrospective study of other multiply-transfused leukemia patients wasconducted to determine how many had been infected with HIV. Informedconsent was obtained from all living patients. Positive enzymeimmunoassay tests were confirmed by Western blot assay.Patients known to have other risk factors for HIV infection wereexcluded from the study.

    Managing Haemophilia And Hiv

    Viewpoint: Why blood transfusions are still giving Indians ...

    Managing haemophilia, HIV and potentially also hepatitis C is a real challenge to an individual, their medical professionals and the people who care for them.

    Someone with all three conditions may have complex needs, both in terms of treatment and support. Its important that the medical professionals monitoring and treating a patient work closely together, so theyre aware of all the issues involved such as drug interactions or adherence issues.

    There have been some studies to investigate anecdotal evidence of bleeding episodes being increased by HIV drugs in the protease inhibitor class. Its not clear why this is the case but its important that doctors treating haemophiliacs with HIV are aware of it.

    If youre living with both conditions, you may feel a range of emotions. Many people in the APPG report describe feeling angry, let down and that their family life has suffered. Find out more about the current inquiry.

    There is support available, although the way its managed has recently changed.

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    What Are The Sources Of Blood For Transfusion

    There are three sources of blood for transfusion:

    • Autologous donation Autologous donation means to receive your own blood. This is normally the safest blood to receive. People of almost any age can donate for themselves, especially prior to surgery or a medical procedure. You may be able to donate for yourself, even if you are ineligible for allogenic donation. Ask your doctor if you are able to self-donate.
    • Designated donation A designated donation is blood donated by a family member or friend.
    • Allogenic blood donation This is blood that’s available from the general blood supply and may be ordered for your needs by your doctor. Various factors, such as donation constraints due to your medical condition, urgency or lack of donors, may necessitate the use of this blood source.

    Hiv Seroprevalence Among Blood Recipients

    People who receive multiple transfusions of blood or blood products, such as those with haemophilia or thalassaemia, are at greater risk of HIV infection through blood than the general population. In the early stages, HIV prevalence among such recipients was quite high nearly 10% in the Islamic Republic of Iran, 3% in Tunisia and 1% in Kuwait . With the establishment of facilities for screening of blood and blood products for HIV, transmission of HIV through this means has decreased considerably over the years. This has been seen consistently in almost all countries which are carrying out surveillance among these risk groups.

    Overall, the HIV seroprevalence among these risk groups has markedly decreased, from 270 per 10 000 during 1987-1989 to 7 per 10 000 in 1995 . Most of the HIV infections reported lately were old infections which were only detected recently, but that a few are new infections cannot be ruled out in countries where universal screening of blood or blood products against HIV has not been secured.

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    Allergic Reactions Infections Fever And Iron Overload Risks And Complications

    A nurse or doctor will stop the transfusion at the first signs of an allergic reaction. The health care team determines how mild or severe the reaction is, what treatments are needed, and whether the transfusion can safely be restarted.

    Viruses and Infectious Diseases

    Some infectious agents, such as HIV, can survive in blood and infect the person receiving the blood transfusion. To keep blood safe, blood banks carefully screen donated blood.

    The risk of catching a virus from a blood transfusion is very low.

    • HIV. Your risk of getting HIV from a blood transfusion is lower than your risk of being killed by lightning. Only about 1 in 2 million donations might carry HIV and transmit HIV if given to a patient.
    • Hepatitis B and C. The risk of having a donation that carries hepatitis B is about 1 in 205,000. The risk for hepatitis C is 1 in 2 million. If you receive blood during a transfusion that contains hepatitis, you’ll likely develop the virus.
    • Variant Creutzfeldt-Jakob disease . This disease is the human version of Mad Cow Disease. It’s a very rare, yet fatal brain disorder. There is a possible risk of getting vCJD from a blood transfusion, although the risk is very low. Because of this, people who may have been exposed to vCJD aren’t eligible blood donors.

    Fever

    Some blood banks remove white blood cells from whole blood or different parts of the blood. This makes it less likely that you will have a reaction after the transfusion.

    Support From Terrence Higgins Trust

    Why might I need a transfusion?

    We are supporting those living with and affected by HIV as a result of the Contaminated Blood Scandal.

    Terrence Higgins Trust, which now manages the remaining funds from the Macfarlane Trust, is providing initially up to 24 free counselling sessions per person. To be eligible, you will be a former MFT beneficiary with or affected by HIV as a result of contaminated blood products.

    To find out more call 0808 8021221 or email .

    Support and advice is also available from THT Direct via email or on 0808 802 1221.

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    Why Do Sickle Cell Patients Need Blood Donors

    Sickle cell is the most common inherited blood disease. It causes red blood cells to form abnormal crescent shapes that often get stuck together when traveling through the body, causing painful clots.

    While a donor from any racial or ethnic group can be a match for a sickle cell patient, the best match for a blood transfusion is from an African-American donor.

    What Is Haemophilia

    Put simply, people with haemophilia bleed for longer if they get a cut. Its an inherited condition which mainly affects men, although women can be carriers and can have a mild form of the condition.

    Haemophilia stops the blood clotting process in the body from working properly. Usually, when someone gets a cut, clotting factors in their blood combine with platelets to make the blood sticky, which stops the bleeding.

    Depending on how much clotting factor the person is missing, their haemophilia could range from mild to severe.

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