Bloodborne HIV: Don't Get Stuck!

Unsterile procedures as a hospital infect 5 women, December 2016: On 30 December 2016 a hospital in Hangzhou, China, injected 34 women with white blood cells from their husbands (the women had miscarried; the treatment was intended to prevent future miscarriages).[1] The technician who prepared the cells reused some tubes without sterilization to handle cells from more than one husband. Unfortunately, one husband was infected with HIV. Reused tubes transmitted HIV from his blood to infect 5 women. The government found this problem by investigating after one  women, on 24 January 2017, told the hospital her husband may have HIV. On 25 January, the hospital started an investigation. The investigation found and fixed the mistake that transmitted HIV, and tested all women who may have been exposed to find the 5 infections.

circa 100,000 blood and plasma donors infected 1990-5: During 1990-94, Chinese companies established thousands of plasma collection centers in poor rural areas of China to buy plasma and blood at from villagers.[2] Not later than 1994, government officials became aware of HIV outbreaks in some collection villages and HIV-contaminated blood and blood products.[3] Government from March 1995 closed all commercial plasma collection centers.[2] This stopped the outbreak. From 2000, international newspapers and medical journals provided partial pictures of what had happened during the early 1990s, such as results from testing people in one or several villages.[4] There is, however, no clear picture of the extent of the disaster. How many blood and plasma sellers got HIV? Estimates range over a million. China’s Ministry of Health and UNAIDS estimated 55,000 former commercial plasma and blood donors were living with HIV in 2005.[5,6] If this is an accurate account of the number alive in 2005, it is an incomplete count of the damage: many donors infected during 1990-95 had died by 2005. Likely the number infected and alive as of 1995 would have been close to 100,000 — far greater than in the next largest recognized nosocomial outbreak in Romania, with an estimated 10,000 children infected during 1989-92.

References

1. Pan X, Jiang J, Ma Q, et al. Outbreak of HIV infection linked to nosocomial transmission, China, 2-16-17. Available at: https://wwwnc.cdc.gov/eid/article/24/12/18-0117_article (accessed 21 November 2018).

2. Wu Z, Rou K, Detels R. Prevalence of HIV infection among former commercial plasma donors in rural eastern China. Health Pol Planning 2001; 16: 41-46. Abstract available at: https://www.ncbi.nlm.nih.gov/pubmed/11238429 (accessed 13 February 2018).

3. Wu Z, Liu Z, Detels R. HIV-1 infection in commercial plasma donors in China [letter]. Lancet 1995; 346: 61-62.

4. Ji G, Detels R, Wu Z, et al. Correlates of HIV infection among former blood/plasma donors in rural China. AIDS 2006; 20: 585-591. Abstract available at: https://journals.lww.com/aidsonline/Abstract/2006/02280/Correlates_of_HIV_infection_among_former.12.aspx (accessed 13 February 2018).

5. Ministry of Health, People’s Republic of China, UNAIDS, and WHO. 2005 update on the HIV/AIDS epidemic and response in China. Ministry of Health, People’s Republic of China, UNAIDS, and WHO. Geneva: UNAIDS, 2006. Available at: http://data.unaids.org/publications/external-documents/rp_2005chinaestimation_25jan06_en.pdf (accessed 12 February 2018).

6. Lu F, Wang N, Wu Z, et al. Estimating the number of people at risk for and living with HIV in China in 2005: methods and results. Sex Transm Infect 2006; 82: siii87-siii91. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2576728/pdf/iii87.pdf (accessed 17 May 2019).