UNRECOGNIZED HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 INFECTION IN A COHORT OF TRANSFUSED NEONATES - A RETROSPECTIVE INVESTIGATION

Objective. To retrospectively identify unrecognized human immunodefici ency virus type 1 (HIV-1) infection among a cohort of children transfu sed as neonates before donated blood was routinely screened for HIV-1 antibody. Methods. Records at a large, private, metropolitan hospital were reviewed to identify children who were transfused as neonates bet ween January 1980 and March 1985 and discharged alive from the hospita l. Multiple data sources were used to locate these children. Parents o r guardians were contacted, and their children were offered HIV-1 anti body testing and physical examination. Results. Of the 775 children id entified as having received transfusions during the project period, 64 4 (83%) were located, and 443 (69%) were evaluated for HIV-1 infection . Among those evaluated, 33 (7%) had antibody to HIV-1, including 14 w hose infections had not been previously diagnosed. At the time of enro llment, 13 children infected with HIV-1 were asymptomatic an average o f 63 months after transfusion. Conclusion. HIV-1 antibody testing shou ld be considered for all children, regardless of clinical status, who were transfused before routine blood donor screening was implemented i n March 1985, particularly in areas with a high incidence of acquired immunodeficiency syndrome during those years.