DECLINING EFFICACY OF AIDS CASE LIST CROSS-REFERENCING IN HUMAN-IMMUNODEFICIENCY-VIRUS LOOK-BACK - 1981 THROUGH 1992

Background: The impact of AIDS case list cross-referencing in human im munodeficiency virus look-back was assessed. Study Design and Methods: Post-1977 blood donations from former donors identified by 11 collabo rating health departments as having developed AIDS have been traced at Irwin Memorial Blood Centers since 1983. To assess the changing effic acy of AIDS case list cross-referencing in identifying infected donors and recipients, trends in cases reported through December 1992 were a nalyzed. Results: Previous donors (n = 638) were identified from 21,91 7 AIDS case listings, for an overall match rate of 2.9 percent. The ra te of detection of previous donors from listings of AIDS cases decline d from a peak of 5.3 percent in 1985 to 1.6 percent in 1992. Overall, 86 percent (1824/2122) of donations by persons later reported on AIDS case lists were made prior to January 1983 when risk exclusion measure s were initiated. Of the 212 known Infected recipients linked to AIDS case list donors, 87 (41%) were previously identified by other look-ba ck approaches. The rate of identification of infected recipients detec ted exclusively through AIDS case listings declined from a mean of 21 per year from 1984 to 1987 to a mean of 3 per year from 1990 to 1992. No transmissions have been documented from donations prior to 1979. Co nclusion: These findings demonstrate the declining yield of AIDS case list Crossreferencing as a trigger for human immunodeficiency virus lo ok-back. Continued reevaluation of look-back prog rams is essential so that their various components may be curtailed when justified.