The CDC estimates five million patients receive blood each year resulting in a total of 14.6 million transfusions per year. People are uneasy when they have to be transfused. The CDC is just one agency testing blood safety. It is distressful to read statements such as this:
Improvements in donor and blood screening have greatly reduced the risk of transmitting disease through blood and blood products. However, transfusion-related infections with known viruses continue to occur, and new and emerging viruses pose potential new threats to the safety of the blood supply.
Medical researchers have determined that the risks of getting HIV or HCV from transfusions in the United States are reassuring. The National Heart, Lung and Blood Institute writes:
Your risk of getting HIV from a blood transfusion is lower than your risk of getting killed by lightning. Only about 1 in 2 million donations might carry HIV and transmit HIV if given to a patient.
Hepatitis B and C. The risk of having a donation that carries hepatitis B is about 1 in 205,000. The risk for hepatitis C is 1 in 2 million. If you receive blood during a transfusion that contains hepatitis, you’ll likely develop the virus.
NHLBI Biologic Specimen Repository’s web site allows to see what research has been done on transfusions, HIV, HCV and many other health issues using the specimens. You will find a substantial body of work has been conducted over the last decades that has added greatly to scientific knowledge.
That said, should you or I consider post-1992 blood transfusions an important risk factor for viruses? I have been debating this for five years since I spent a weekend in a hospital getting five units of blood. I was assured that I received safe blood but after lots of tests, they could not determine if I needed the blood because of my beta thalassemia or from a GI bleed from an anti-inflammatory medication I was on then.
What would stop me from getting tested even if I wasn’t worried about my transfusion? Would asking for a test make me look immoral or perhaps a hypochondriac? The fact is I’m not alone in avoiding the issue. According to 2013 Kaiser Foundation data, Percentage of Persons Aged 18-64 Who Reported Ever Receiving an HIV Test, about 43.7% have ever been tested. A few numbers by state to ponder: MN: 32.6 %; VT: 36.4%; WV: 38%.
In 2013, the VA was treating 26,784 for HIV making it the largest HIV provider in the country. Yet veterans ever tested remain low. According to this VA slide presentation in 2009, fewer than 10% of veterans in care had ever been tested for HIV. In 2011, only 20% had been tested.
Medicare will pay for a one HCV screening if ordered by a primary physician or under certain other conditions here. That removes a significant financial barrier. Medicare Part B will pay for an HIV screening once a year with these conditions here.
Why are Americans so reluctant to get tested? Fear? Stigma? Don’t we owe it to our grandchildren to take care of ourselves so we can be there for them? And why don’t our doctors suggest screening if only for our peace of mind? Frankly, even writing this post about HIV and HCV screening stresses me out. I need to go lie down now…
More related resources:
WHO Fact Sheet # 279 June 2014, Blood safety and availability
WHO 2009 booklet: Screening donated blood for transfusion-transmissible infections: recommendations
I’m impressed and grateful for their hard work as unpaid donors.