Transmission of human immunodeficiency virus through blood transfusion: the use of lookback and traceback approaches to optimize recipient identification in a regional population.

BACKGROUND: The purpose of this study was to define the epidemiologic features of the transmission of human immunodeficiency virus (HIV) by blood transfusion in a region of Canada between 1980 and 1985 and the results of intensive recipient-identification practices. STUDY DESIGN AND METHODS: Lookback (notification of all recipients of blood from an HIV-infected donor) and traceback (identification of the HIV-infected source donor, after an HIV-infected recipient of blood cites transfusion as a risk for infection) programs were established linking (with patient consent) a transfusion service and an HIV clinic to identify HIV-infected donors and the recipients of their blood.
RESULTS: Twenty-two cases of documented HIV infection and 26 cases of presumed infection were found in local blood recipients. Twenty-eight recipients have died of causes unrelated to HIV. Twelve recipients have developed AIDS. Six of the seven living recipients have yet to develop an AIDS condition. These 48 infections have been linked to 11 donors who have subsequently tested positive for HIV infection. Six donors were found on subsequent blood donation. Five donors were found by traceback.
CONCLUSION: Forty-eight recipients of blood from donors who subsequently tested positive for HIV were identified in a low-prevalence area. Active lookback and traceback programs linking a transfusion service and an HIV clinic were successful in identifying infected recipients.