A colleague in Brazil reports that in his experience, HIV-infected patients do not appear to be at significant risk for TA-GVHD, even though such patients are immunologically impaired and ostensibly at high risk for long-term persistence and expansion of donor WBCs. He acknowledges that at his blood center in Brazil they do not irradiate blood products merely because a patient has HIV/AIDS, although they do leukocyte reduce cellular blood products before transfusion to these patients. He adds that HIV is a huge problem in his area, and they are transfusing many patients who are receiving anti-viral drugs. Although he is unaware of any cases of TA-GVHD among HIV/AIDS patients in his area, he is aware of a 1996 report of a possible instance of transfusion-associated GVHD that has been reported in a child. He wonders what other institutions are doing with regards to providing (or not providing) irradiated blood products for HIV infected patients.

Webmaster's Note: Colleagues may be interested in reviewing a study pertinent to this question, by Kruskall and co-workers from the VAT Study group reported in Blood, 2001, entitled 'Survival of transfused donor white blood cells in HIV-infected recipients'.

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Ira A. Shulman, MD
CBBS e-Network Forum Editor & Moderator