THE ROLE OF COMMERCIAL PLASMAPHERESIS BANKS ON THE AIDS EPIDEMIC IN MEXICO

Objective. To characterize the circumstances underlying the epidemic o f AIDS associated with blood transfusion in Mexico and to explore the possible mechanisms for its dissemination. Methods. A retrospective an alysis comparing the total number of AIDS cases and transfusion-associ ated AIDS cases and the male:female ratio reported in Mexico and the U .S, from 1981 to 1996 was done. We analyzed the relationship between t he location of plasmapheresis banks and the geographic distribution of transfusion-associated AIDS cases and AIDS cases among paid donors in order to assess the possible role of plasmapheresis banks in its diss emination. Results. The proportion of transfusion-associated AIDS in t he total number of cases was significantly higher in Mexico than in th e U.S. from 1987 through 1996 (p < .0001). A rapid drop in the male:fe male ratio of AIDS was observed in Mexico but not in the U.S. coincidi ng with a growing number of transfusion associated cases; transfusion has been the main risk factor for AIDS in women in our country. In 198 6, seven States and Mexico City had plasmapheresis banks: they reporte d 90% of the cases associated to paid donation and 75% of those associ ated to transfusion, despite the fact that commercial blood banks with out plasmapheresis facilities existed in 23 of the other 24 States. Co nclusion. There was a difference on the frequency of transfusion assoc iated AIDS between Mexico and the U.S. which reached epidemic proporti ons in Mexico. We believe that plasmapheresis banks played a major rol e in the dissemination of the infection in Mexico as paid donors provi ded a third of the blood used in Mexico in 1986. These findings highli ght important implications for the prevention of AIDS in developing co untries where commercial plasmapheresis practices are still in operati on.