[A retrospective cohort study on the natural history of AIDS caused by blood transfusion].

OBJECTIVE: To study the natural history of AIDS, caused by blood transfusion. METHODS: All HIV infections and AIDS patients were from Hebei province, including those infected through blood transfusion around 1995, that were identified as through general census of former commercial plasma donors (FCPDs). Among those objects being observed during the incubation period, 354 had HIV infections (including 142 cases infected via plasmapheresis and 212 cases caused by transfusion) but had not been treated by HAART before the onset of disease. Objects being observed during the survival period, 141 were AIDS patients (including 57 cases infected via plasmapheresis and 84 cases causes by transfusion) but had not been treated by HAART before and after the onset of disease. All infectors and AIDS patients were under follow-up on the progress of illness or death, respectively. RESULTS: By December 31, 2010, the cumulative incidence among HIV infections was 88.70% (314/354), with the incidence density as 9.14/100 person-years (314/3435.75) and the median incubation period was 113 months. Of 142 HIV infections in the blood donation group and 212 infections in the blood transfusion group, the incubation periods were 112 months and 115 months, respectively. All of the 141 patients died 34 months after the onset, with the death-strength as 204.70/100 person-years (141/68.88) and the period of survival was 4 months. Among those 57 FCPDs infections, they were all died 24 months after the onset, with the death-strength as 250.66/100 person-years (57/22.74) and the survival was 3 months. The other 84 infections who were blood recipients, all died 34 months after the onset, with the death-strength as 182.05/100 person-years (84/ 46.14) and the survival was 4 months. CONCLUSION: Through this study, we noticed that the natural history of all the AIDS patients was caused by blood transmission. It was important to evaluate the natural history of HIV epidemics among both FCPDs and blood recipients, occurred before and after 1995.

[Retrospective cohort study on period of incubation and survival among former commercial plasma donors infected with HIV in Hebei province].

OBJECTIVE: To examine the state of incubation period and survival time of former commercial plasma donors (FCPDs) infected with HIV. METHODS: All objects infected with HIV were from Hebei province and found from general investigation for FCPDs in 1995. The infector cohort by 142 cases was used to estimate incubation period. In the infector cohort, the time which infectors entered the cohort was their infection time, which was the middle value of the origin date, which was January 1, 1995. The onset of AIDS was defined as an outcome event. End point of observation was Dec 31, 2010. There were 192 months in all from beginning to end. The AIDS cohort by 57 cases was used to estimate the survival of the patients. In the patient cohort, the time of AIDS onset was defined as the time entering the cohort, and death of AIDS was defined as an outcome event. The cumulative incidence ratio, cumulative mortality, illness intensity and mortality intensity were analyzed through Kaplan-Meier. RESULTS: During the observation period, 123 cases of 142 infectors developed into AIDS, the cumulative incidence was 86.42% (123/142) and the intensity was 8.53/100 person-years and the median time of incubation period was 112.0 months (95%CI: 108.8 - 115.2). The death dates of 57 patients were from 1 to 24 months after onset. The cumulative mortality was 100%, and the intensity was 250.66/100 person-years and the median survival time was 3.0 months (95%CI: 1.8 - 4.2). It was estimated that the median time was 115.0 months (9.6 years) from infection to death. CONCLUSION: The median times of incubation and median survival time were 112.0 and 3.0 months, respectively.

[Retrospective cohort study on the rate of mother-to-child transmission among mothers infected with human immunodeficiency virus type 1 through blood transfusion].

OBJECTIVE: To study the rate of mother-to-child transmission (MTCT) on HIV-1. METHODS: All local residents from 8 townships in a region were screened for mothers who had a history of only one blood transfusion and 63 were found HIV-1 positive. A further study on these HIV-1 positive mothers and their children was conducted with the emphasis on the date of receiving blood transfusion, date and type of nationality, history regarding breastfeeding and so on. Sera specimens from 84 children born from 63 HIV-1 positive mothers were screened, using ELISA for HIV-1 antibody, and positive specimens were confirmed by Western-blot. RESULTS: The rate of MTCT was 32.1% (27/84) for children with all risk factors related to MTCT. Another 36.8% (7/19) were related to factors on intrauterine, intrapartum and breastfeeding, 35.7% (5/14) to intrapartum and breastfeeding factors, 14.3% (2/14) to intrauterine and intrapartum factors, 37.9% (11/29) to breastfeeding factor alone. By group combination analysis, the MTCT rate was 36.9% (24/65) with breastfeeding, 11.8% (2/17) with artificial feeding, and the former was significantly higher than the latter. CONCLUSION: HIV-1 MTCT rate among mothers caused by a single blood transfusion varied with different risk factors. Breastfeeding played an important role in MTCT, appeared in our study.