Contracting HIV From Organ Donors & Other Medical Procedures…

Throughout the past week, I’ve been watching in the news media about the four individuals who got HIV after receiving organ transplants. On the local and cable television news networks, I have heard so much about how this could have happened, and what’s being done (via the government probe) about it. Via the Internet (especially the blogs) it’s more about … well … paranoia.

It’s starting to seem like every time I get an e-mail, read a blog or network post, I read something that contradicts what I read ten minutes before. It’s all so confusing. One guy says: This hasn’t happened before. The next guy says: That information came from an unreliable source, there have been a few, but they are rare. The next guy says: We need to have a better system in place so this doesn’t happen again. The next guy says: The system we have works great, why not just leave it alone. The next guy says: This hasn’t happened before. The next guy…

It’s hard to know how to respond. Not to sound like I am imitating Grissom on CSI - But, what evidence does the science give us?

The Basic Facts of the Case: Four patients got HIV from infected transplant organs. The gentleman who donated his organs had been exposed to HIV a matter of days before the transplant. As a matter or procedure, all organs are given Rapid HIV Tests before transplant.

The situation: The Rapid HIV Test is a very accurate test when accurately performed (and they’re easy to do). According to the CDC Website about the Tests used:

In the clinical studies by the manufacturer (OraSure Technologies, Inc.), the OraQuick test correctly identified 99.6% of people who were infected with HIV-1 (sensitivity) and 100% of people who were not infected with HIV-1 (specificity). The Food and Drug Administration expects clinical laboratories to obtain similar results.

So the test has an accuracy rate of 99.6% with no false positives. All in all, it’s the most accurate rapid test available.

Here is another fact some may find surprising. The Rapid HIV Test does not actually test for HIV itself, but rather for the antibodies the body produces when it is infected by HIV.

The Problem: When the human body is infected by HIV, it takes time for it to produce the antibodies. For some people, it could take the body a matter of days for the body to produce the antibodies, for others it may take longer. The reason for this is that everyone has different body chemistry and there’s no possible way of knowing how long it will take to produce the antibodies. (Think of it this way: when I get a headache, I take two Advil and it goes away. My roommate gets a similar headache, takes four Advil, and it barely takes the edge off. Why? Because our bodies are different.)

One of the questions I’ve heard over and over again is: Are there any tests that test for the virus itself? The answer is yes, but it’s not any better. For example, doing a viral lode test (which tests how many HIV viruses are contained in a unit of blood) is one costly example - however the test takes much longer to perform and the most sensitive tests can not detect HIV if there are less than fifty viruses per unit of blood. In persons who were infected with HIV in a matter of days before this test, it still may not show up.

With other tests, similar restrictions still apply.

The Solution: The bottom line is that there really, at this point, is no direct solution. But, maybe this can be a wake up call for us to find one.

There is an old saying that goes: “In life, there is no 100%.” In other words, nothing works 100% of the time. It’s unfortunate, and sometimes it totally sucks, but it’s something that we as human beings need to deal with.

Or, maybe this should be a wake up call. HIV can happen to everyone, even those without high risk factors. The one question I haven’t heard through all this:

What can we do to help people who have been infected (or affected) by HIV?