Four infected with HIV and HCV after receiving organs in Chicago

This article is more than 17 years old.

Four transplant recipients have been infected with HIV and hepatitis C virus (HCV) because the donor had undiagnosed HIV and HCV infections.

The transmissions occurred in Chicago. Tests on the donor did not show any signs of HIV or HCV, but it is thought that the individual had recently acquired both infections and standard antibody blood tests were not yet able to detect the infection. The cases are reported in the Chicago Tribune.

Before the donor’s organs were removed it was known that the individual had high-risk behaviours for both HIV and hepatitis C acquisition.

Glossary

enzyme-linked immunosorbent assay (ELISA)

A diagnostic test in which a signal produced by an enzymatic reaction is used to detect and quantify the amount of a specific substance in a solution. Can be used to detect antibodies to HIV, p24 antigen or other substances.

Food and Drug Administration (FDA)

Regulatory agency that evaluates and approves medicines and medical devices for safety and efficacy in the United States. The FDA regulates over-the-counter and prescription drugs, including generic drugs. The European Medicines Agency performs a similar role in the European Union.

This is the first time that transplant recipients have been infected with HIV in the US since screening was introduced over 20 years ago. However, three patients in Italy were recently infected with HIV after receiving organs from an HIV-positive individual after the tissue was incorrectly labelled.

The donor in Chicago was tested for HIV and hepatitis C using standard ELISA antibody tests. But such tests are not able to detect very recent infections as the body has not yet developed antibodies in response to the infection.

No other transplant patients are at risk as they did not receive tissue from the infected donor.

HIV and hepatitis C were diagnosed in the transplant recipients about three weeks after they received their organs.

Screening programmes and testing in the UK have so far ensured that both organ and blood supplies are free from HIV and hepatitis.

Individuals with a high risk of HIV and other blood-borne infections are banned from donating blood in the US and UK. The Food and Drug Administration in the US recently upheld this ban. Some activists on both sides of the Atlantic claim that this is ‘discriminatory’ to gay men who have not had unprotected sex. However, HIV has entered the US blood supply after a donor failed to mention risky activity. Antibody and nucleic acid tests failed to detect that the man had been recently infected with HIV.

There is good evidence that efforts to protect the UK blood supply work well. Organ donors have HIV antibody tests in the UK, and the families of donors are interviewed to see if the individual had any behaviour that could have involved a risk of HIV.