Blood transfusion and HIV - what you need to know

What is a blood transfusion?

A blood transfusion is the transfer of blood or blood products from one person (donor) into another person's bloodstream (recipient). This is usually done as a lifesaving manoeuvre to replace blood cells or blood products lost through severe bleeding, during surgery when blood loss occurs, or to increase the blood count in anaemic patient.

In the early days of the HIV epidemic, there was little information about which fluids contained the HI-virus. Although donated blood was screened, the methods did not accurately screen for HIV. At that time, there were many infections among people who received blood transfusions because of trauma or diseases. This was particularly high among haemophiliacs. The blood of people with haemophilia lacks various clotting factors, which means that they regularly require transfusions of blood or blood products.

If a person who is HIV-positive donates blood products such as an organ or tissue, the person who receives the blood product is likely to develop an HIV infection, too. To prevent this, blood products are tested for HIV before they are given to anyone.

Blood-testing guidelines

International guidelines state that all blood products must be tested for viruses such as HIV, therefore, over the years, many highly effective methods have been developed by blood transfusion services (BTS) to ensure HIV-free blood supplies. BTS also takes all possible precautions to ensure that nobody who is HIV-positive donates blood.

High-income countries test and screen all blood products which will identify those that need to be disposed of if they contain HIV.

Some low-income countries lack the equipment to test all blood, so there have been some examples of donated blood products containing HIV. However, this is still very rare and people who donate blood are often asked questions that will help determine if they have been at risk of HIV infection in the past.

In most cases, the blood product you are receiving is safe. However, if you are worried, it is your right to ask the health-care professional if it has been tested for HIV or not.

Persons who may be banned from donating blood

In some countries, certain groups of people are banned from donating blood products for a specific period of time because they are more likely to be HIV-positive. The main reason for the ban is that they may be infected with HIV, but it hasn't shown up on a HIV test as yet (it can take up to three months after infection for HIV to show up on a test).

Groups of people that may be banned for some time, or for life, include men who have sex with men, sex workers, and people who inject drugs. Certain activities such as having a tattoo or body piercing, or if you are living with a certain health condition, may also mean you can't donate blood for a while.

If you fall under one of these groups of people, tell a health-care professional and they can advise you whether it's safe to donate blood or not.

There are also other factors that could contribute to someone not being able to donate blood, such as:

- Low HB (haemoglobin)

- Medication (presently being taken)

- Miscarriage (past six months)

- Recent skin piercing or tattoos

- Cancer

- Diabetes

Some people think that donating blood is a better way to learn their HIV status than asking their doctor for an HIV test or visiting a clinic. This is not true. You should not donate blood to find out if you are HIV-positive. Why? Because the HIV tests used to screen donor blood are highly accurate - but they aren't perfect. If you have been infected with HIV recently, even the most sensitive test may not show it, and you can infect others if your blood is transfused to them.

If you have engaged in high-risk sexual or drug-taking behaviours, you should not donate blood. It is important, though, to learn your HIV status. You can get an HIV test at a number of places, including your local health department, public health clinic, doctor's office or at many local AIDS service organisations or community-based organisations. By getting an HIV test, you can protect your own health, as well as the health of people who need blood. It is also possible to purchase a rapid home-use HIV test kit.

Note to donors

When donating blood, if you have concerns about how sterile the needle is that is being used, you don't have to worry. The empty blood pack has its own needle, and when used it is dumped. The site of the venipuncture is then cleaned with a sterile solution. A brand new needle is used for each blood donation. Once it is used, the needle is destroyed.

If you suspect that the needle your health-care worker is using is not new or sterile, then ask them to change the needle before agreeing to give blood.

Blood transfusion facts

- Blood transfusions can be a life-saving measure.

- Volunteer donor blood usually is readily available, and, when properly tested, has a low incidence of adverse events.

- The likelihood of contracting infections from a blood transfusion is very low (varies with the infectious agent from one in 350,000 to one in one million), but can occur.

- Transfusion of your own blood (autologous) is the safest method but requires planning ahead, and not all patients are eligible. It is usually only an option for elective surgery.

- Directed donor blood allows the patient to receive blood from known donors.

- Blood-conserving techniques are an important aspect of limiting transfusion requirements.

- Blood banks are responsible for collecting, testing and storing blood.

- People with Type O negative blood are considered universal donors as it is safe to transfuse to nearly everyone.

- Most of the time a transfusion is not a 'whole blood' transfusion, but rather certain blood products, with red blood cells being the most common.

- Jendy McDonald is an AIDS educator with Positive Impact Ministries and a 'Channel of Hope' facilitator with AIDS Link International, South Africa.

Email: positiveimpactministries1@gmail.com; yourhealth@gleanerjm.com