Hepatitis B carrier state produced by a blood transfusion

HIV infection due to a platelet transfusion after allogeneic bone marrow transplantation

A 30-yr-old man with chronic granulocytic leukaemia received a bone marrow transplant from his histocompatible sister in December 1982. His post-transplant course was complicated by Grade III graft-versus-host disease and multiple infectious episodes until his death from pneumonia on d + 190. He was later found to be seropositive for anti-HIV at the time of his death. Retrospective analysis of stored sera showed a transient period of seropositivity from d + 11 to d + 20 thought to reflect passive transfer of antibody from a blood product transfused prior to d + 11 when he was also exposed to infectious virus. He remained seronegative until d + 78 when anti-HIV was again found. Seropositivity persisted until his death and was attributed to endogenous antibody response. Although it is unclear whether his clinical course was due to AIDS, exposure of an immunosuppressed patient to HIV may be associated with more rapid development of clinical disease.

Hepatitis B in the Cambridge dialysis and transplant unit 1966-1983

The results of hepatitis B surveillance of the Cambridge dialysis and transplant units from June 1969 to July 1983 are reported. On admission 34/528 (6.44%) haemodialysis patients had anti-HBc. Preadmission screening excluded 19 HBs Ag carrier patients and two carrier staff. Eight patients became antigenaemic after admission and two others were found to be antigenaemic post-transplantation but pretransplant sera were not available from them. These two had active hepatitis and of the others, seven had asymptomatic carriage and one had acute hepatitis during haemodialysis. Two infected patients were admitted temporarily and one antigenaemic organ donor identified retrospectively. No cross infection occurred on the unit and the only instance of accidental infection of a member of staff was from an outpatient.