THE AIDS EPIDEMIC AND COMMERCIAL PLASMAPHERESIS

In 1986 an epidemic of HIV infection among paid plasma donors was iden tified in Mexico; paid donors were iatrogenically infected in a plasma pheresis center. These paid donors sold both plasma and blood: they pr ovided one-third of blood consumed in 1986. This led to infection of b lood recipients, mainly women of childbearing age. Blood transfusion i s the leading cause of AIDS in women in Mexico. The male:female ratio decreased from 30:1 in 1986 to 5:1 1990; that coincided with the incre ase of transfusion-associated AIDS cases. Mexico prohibited the blood trade in 1987, ending the epidemic in paid donors and recipients. latr ogenic infection of paid donors in plasmapheresis facilities could hel p to explain the explosive AIDS epidemic in central Africa and Haiti i n the 1980s. There is a temporal and geographical coincidence in the e arly eighties between that AIDS epidemic, high numbers of hepatitis B asymptomatic carriers and an increased production of serum inactivated hepatitis B vaccine. Plasmapheresis facilities in these developing co untries may have taken advantage of the high prevalence of hepatitis B asymptomatic carriers in their populations to obtain plasma for expor tation through brokers to developed countries where the vaccine and ot her plasma products were manufactured. This hypothesis is relevant to establishing preventive policies and warrants further investigation.