Louie, who is to receive a blood transfusion asks the nurse what is the most common type of infection he could receive from the transfusion. The nurse teaches him that approximately 1 in 250,000 patients contract:
A. Human immunodeficiency disease (HIV)
B. Hepatitis C infection
C. Hepatitis B infection
D. West Nile viral disease
Correct Answer: C. Hepatitis B infection
Hepatitis B is the most common infection spread via blood transfusion. Donors are screened by a questionnaire that includes symptoms. The donated blood is also tested for infection. The risk of infection with the agents in options 2 and 3 has decreased to approximately 1 in 2 million secondary to donor questioning and donor blood testing. HBV is transmitted hematogenously and sexually. The outcome of this infection results from a complicated viral-host interaction that produces an acute symptomatic disease, an asymptomatic disease, or a chronic carrier state. Later consequences include cirrhosis and the development of hepatocellular carcinoma (HCC).
Option A: The human immunodeficiency virus (HIV), a member of the Lentivirus family of retroviruses, is the causative agent of acquired immunodeficiency syndrome (AIDS). In the United States, more than 1.2 million people are living with HIV, and 1 in 8 of them don’t know it. Individuals who engage in male-male sexual behavior accounted for 82% (26,375) of HIV diagnoses in men and 67% of all diagnoses in 2015. [17] Less than 1% of HIV cases are attributed to blood or blood product transfusions.
Option B: The hepatitis C virus (HCV) is a spherical, enveloped, single-stranded RNA virus belonging to the Flaviviridae family. The World Health Organization (WHO) estimates that 170 million individuals worldwide are infected with HCV, with a wide variation in the prevalence of the disease. For example, in 2000, Frank et al reported that Egypt had the highest number of reported HCV infections, largely attributed to the use of contaminated, parenteral, antischistosomal therapy. [34] This led to a mean 22% prevalence of HCV antibodies in persons living in Egypt. According to the CDC, an estimated 1.8% of the US population is positive for HCV antibodies.
Option D: The incidence of West Nile viral transmission is unknown, but donor infection is still relatively rare. The West Nile virus (WNV), a flavivirus, is transmitted by mosquito bites. The organism has the potential of being transmitted through blood. The infection is usually asymptomatic and goes undetected, but it may cause meningoencephalitis, especially in individuals who are older and who have depressed immunity, with a mortality rate of about 2.6%. In 2002, there were about 9858 cases of WNV infection reported to the CDC.