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Failure To Develop HIV Infection after Receipt of HIV-Contaminated Blood and Postexposure Prophylaxis

2000; American College of Physicians; Volume: 133; Issue: 1 Linguagem: Inglês

10.7326/0003-4819-133-1-200007040-00005

1539-3704

Terese L. Katzenstein, Ebbe Dickmeiss, Hassan Aladdin, Adam Hede, Claus Nielsen, Helle Winter Nielsen, Louise B. Jørgensen, Jan Gerstoft,

HIV, Drug Use, Sexual Risk

Brief Communications4 July 2000Failure To Develop HIV Infection after Receipt of HIV-Contaminated Blood and Postexposure ProphylaxisTerese L. Katzenstein, MD, PhD, Ebbe Dickmeiss, MD, DrMedSci, Hassan Aladdin, MSc, Adam Hede, MD, Claus Nielsen, MSc, PhD, Helle Nielsen, BA, Louise B. Jørgensen, MSc, PhD, and Jan Gerstoft, MD, DrMedSciTerese L. Katzenstein, MD, PhDFrom National University Hospital Rigshospitalet and State Serum Institute, Copenhagen, Denmark.Search for more papers by this author, Ebbe Dickmeiss, MD, DrMedSciFrom National University Hospital Rigshospitalet and State Serum Institute, Copenhagen, Denmark.Search for more papers by this author, Hassan Aladdin, MScFrom National University Hospital Rigshospitalet and State Serum Institute, Copenhagen, Denmark.Search for more papers by this author, Adam Hede, MDFrom National University Hospital Rigshospitalet and State Serum Institute, Copenhagen, Denmark.Search for more papers by this author, Claus Nielsen, MSc, PhDFrom National University Hospital Rigshospitalet and State Serum Institute, Copenhagen, Denmark.Search for more papers by this author, Helle Nielsen, BAFrom National University Hospital Rigshospitalet and State Serum Institute, Copenhagen, Denmark.Search for more papers by this author, Louise B. Jørgensen, MSc, PhDFrom National University Hospital Rigshospitalet and State Serum Institute, Copenhagen, Denmark.Search for more papers by this author, and Jan Gerstoft, MD, DrMedSciFrom National University Hospital Rigshospitalet and State Serum Institute, Copenhagen, Denmark.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-133-1-200007040-00005 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Use of HIV-antibody screening of blood donated for transfusions has reduced the risk for HIV transmission. However, because of the lag time between acquisition of HIV infection and development of antibodies (the window period), some HIV-infected blood donors escape detection (1, 2). Currently, the window period is estimated to be 3 weeks (3). We report a case in which transfusion of HIV RNA–positive, HIV-seronegative blood did not lead to infection in the recipient, most likely because potent postexposure antiretroviral therapy was initiated promptly and followed thoroughly.Case ReportPatient D-1 developed fever and a follicular confluent rash. No exposure to ...References1. Cumming PD, Wallace EL, Schorr JB, Dodd RY. Exposure of patients to human immunodeficiency virus through the transfusion of blood components that test antibody-negative. N Engl J Med. 1989;321:941-6. CrossrefMedlineGoogle Scholar2. Lackritz EM, Satten GA, Aberle-Grasse J, Dodd RY, Raimondi VP, Janssen RS, et al . Estimated risk of transmission of the human immunodeficiency virus by screened blood in the United States. N Engl J Med. 1995;333:1721-5. CrossrefMedlineGoogle Scholar3. Schreiber GB, Busch MP, Kleinman SH, Korelitz JJ. The risk of transfusion-transmitted viral infections. The Retrovirus Epidemiology Donor Study. N Engl J Med. 1996;334:1685-90. CrossrefMedlineGoogle Scholar4. Council of Europe. Guide to the Preparation, Use and Quality Assurance of Blood Components. 5th ed. Strasbourg: Council of Europe Publishing; 1999. Google Scholar5. Schockmel GA, Balavoine JF, Yerly S, Perrin L. Use of highly sensitive assays for the evaluation of post-exposure HIV prophylaxis. AIDS. 1998;12:1726-7. MedlineGoogle Scholar6. Nielsen C, Nielsen CM, Petersen JL, Gøtzche PC, Pedersen C, Arendrup M, et al . Isolation of HIV from cultures of purified CD4+ lymphocytes. J Virol Methods. 1991;35:15-25. CrossrefMedlineGoogle Scholar7. Eugen-Olsen J, Iversen AK, Garred P, Koppelhus U, Pedersen C, Benfield TL, et al . Heterozygosity for a deletion in the CKR-5 gene leads to prolonged AIDS-free survival and slower CD4 T-cell decline in a cohort of HIV-seropositive individuals. AIDS. 1997;11:305-10. CrossrefMedlineGoogle Scholar8. Schuurman R. State of the art of genotypic HIV-1 drug resistance. 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Seroconversion rate, mortality, and clinical manifestations associated with the receipt of a human immunodeficiency virus-infected blood transfusion in Kinshasa, Zaire. J Infect Dis. 1991;164:450-6. CrossrefMedlineGoogle Scholar13. Donegan E, Stuart M, Niland JC, Sacks HS, Azen SP, Dietrich SL, et al . Infection with human immunodeficiency virus type 1 (HIV-1) among recipients of antibody-positive blood donations. Ann Intern Med. 1990;113:733-9. LinkGoogle Scholar14. Donegan E, Lenes BA, Tomasulo PA, Mosley JW, Mosely JW. Transmission of HIV-1 by component type and duration of shelf storage before transfusion. Transfusion. 1990;30:851-2. CrossrefMedlineGoogle Scholar15. Samson M, Libert F, Doranz BJ, Rucker J, Liesnard C, Farber CM, et al . Resistance to HIV-1 infection in Caucasian individuals bearing mutant alleles of the CCR-5 chemokine receptor gene. Nature. 1996;382:722-5. CrossrefMedlineGoogle Scholar16. Connor EM, Sperling RS, Gelber R, Kiselev P, Scott G, O'Sullivan MJ, et al . Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. N Engl J Med. 1994;331:1173-80. CrossrefMedlineGoogle Scholar17. Cardo DM, Culver DH, Ciesielski CA, Srivastava PU, Marcus R, Abiteboul D, et al . A case–control study of HIV seroconversion in health care workers after percutaneous exposure. Centers for Disease Control and Prevention Needlestick Surveillance Group. N Engl J Med. 1997;337:1485-90. CrossrefMedlineGoogle Scholar18. Wade NA, Birkehead GS, Warren BL, Charbonneau TT, French PT, Wang L, et al . Abbreviated regimens of zidovudine prophylaxis and perinatal transmission of the human immunodeficiency virus. N Engl J Med. 1998;339:1409-14. CrossrefMedlineGoogle Scholar19. Tsai CC, Follis KE, Sabo A, Beck TW, Grant RF, Bischofberger N, et al . Prevention of SIV infection in macaques by (R)-9-(2-phosponylmethoxypropyl)adenine. Science. 1995;270:1197-9. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Terese L. Katzenstein, MD, PhD; Ebbe Dickmeiss, MD, DrMedSci; Hassan Aladdin, MSc; Adam Hede, MD; Claus Nielsen, MSc, PhD; Helle Nielsen, BA; Louise B. Jørgensen, MSc, PhD; Jan Gerstoft, MD, DrMedSciAffiliations: From National University Hospital Rigshospitalet and State Serum Institute, Copenhagen, Denmark.The data were first reported at the Third International Workshop on HIV Drug Resistance & Treatment Strategies, San Diego, California, 23–26 June 1999 (Antiviral Therapy. 1999;4[Suppl 1]:124).Acknowledgment: The authors thank Jesper Eugen-Olsen for performing the CCR5 genotyping.Corresponding Author: Terese L. Katzenstein, MD, PhD, Department of Infectious Diseases, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø , Denmark; e-mail, [email protected]dk.Current Author Addresses: Drs. Katzenstein, Aladdin, and Gerstoft and Ms. Nielsen: Department of Infectious Diseases, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø , Denmark.Dr. Dickmeiss: Department of Clinical Immunology, National University Hospital Rigshospitalet, Tagensvej 20, DK-2200 Copenhagen, Denmark.Dr. Hede: Department of Pediatric Orthopedic Surgery, National University Hospital Rigshospitalet, Tagensvej 20, DK-2200 Copenhagen, Denmark.Drs. Nielsen and Jørgensen: Retrovirus Laboratory, State Serum Institute, Artillerivej 5, 2300 Copenhagen S, Denmark.Author Contributions: Conception and design: T.L. Katzenstein, E. Dickmeiss, C. Nielsen, J. Gerstoft.Analysis and interpretation of the data: T.L. Katzenstein, H. Aladdin, C. Nielsen, H. Nielsen, L.B. Jørgensen, J. Gerstoft.Drafting of the article: T.L. Katzenstein.Critical revision of the article for important intellectual content: C. Nielsen, J. Gerstoft.Final approval of the article: E. Dickmeiss, H. Aladdin, A. Hede, C. Nielsen, H. Nielsen, L.B. Jørgensen, J. Gerstoft.Provision of study materials or patients: T.L. Katzenstein, E. Dickmeiss, A. Hede.Collection and assembly of data: T.L. Katzenstein. 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