HIV from local blood transfusion

smartalex · #1 29-12-2006, 08:40 PM

I have a friend whose mom died from a HIV related illness days ago. The doctors at TTSH have confirmed that daddy is not responsible (HIV negative) and mommy is too religious and also too old to be fooling around. The only possibility is HIV transmission from a recent surgery using pre-seroconversion blood or blood products.

Most people don't realize that blood transfusion is not guaranteed to be virus-free. Neither is it as safe as the doctors and MOH make it out to be. Assholes who fool around, got themselves infected and donated blood during the window period are responsible for this. Please refer here for more info:
http://jama.ama-assn.org/cgi/content/abstract/284/2/210

Whatever forms you signed to authorize the blood transfusion and/or surgery has mostly removed your rights to legal action. If you are the unlucky 1 in 225,000 people to get it, it is just bloody damning. That was how I felt seeing the cursed granny in the coffin.

samfan · #2 30-12-2006, 12:14 AM

First my condolence to your friend's family. However, the chances of HIV infection through blood transfusion is remotely possible in present day Singapore. The possible explanation is that the patient received a blood transfusion prior to 1985 - before the US CDC identified the HIV virus.

Since 1985 all donated blood in Singapore is tested for HIV and all contaminated specimens are destroyed. In addition, all persons engaging in high risk activities are advised not to donate blood. Therefore, the blood supply in Singapore is almost totally safe.

There is absolutely no risk of catching HIV when donating blood because all equipment used (needles, syringes, tubing and containers) is sterile, used only once and thrown away.

smartalex · #3 30-12-2006, 01:22 AM

Quote:

Originally Posted by samfan

First my condolence to your friend's family. However, the chances of HIV infection through blood transfusion is remotely possible in present day Singapore. The possible explanation is that the patient received a blood transfusion prior to 1985 - before the US CDC identified the HIV virus.

You don't know the facts of this case. The granny was never on anti-retroviral medication until 1-2 months ago. She couldn't have gotten HIV prior to 1985 and lived till this year without proper medication.

When HSA or any blood donation or transfusion centers claim a very remote risk of HIV, it just means about a 1 in 225,000 chance of infection. This granny was that unlucky one.

No blood bank in this world can guarantee a ZERO risk of HIV transmission. Doctors out here can verify my statements.

Quote:

Originally Posted by samfan

Since 1985 all donated blood in Singapore is tested for HIV and all contaminated specimens are destroyed. In addition, all persons engaging in high risk activities are advised not to donate blood. Therefore, the blood supply in Singapore is almost totally safe.

This is international practice, but cannot guarantee ZERO risk. Almost totally safe, but NOT totally safe. HSA will be sued bankrupt if they have the balls to claim 100% safe.

Quote:

Originally Posted by samfan

There is absolutely no risk of catching HIV when donating blood because all equipment used (needles, syringes, tubing and containers) is sterile, used only once and thrown away.

If you have any basic training in microbiology at all, you will understand that this has no bearing on HIV transmission from a contaminated donor at all. What you are referring to are good laboratory practices. I have no doubt that the needles, etc that HSA use during blood donation are sterile and clean.

The greatest contributor to reducing risks today is due to the very sensitive panel of tests used to determine the presence of the tinest amount of HIV RNA. But sensitivity is a statistical term, so we can only talk about possibilities. So at best we can say it is a very very remote risk. But the doctor or technicians can never ever say 100% clean - confirm, chop and sign.

For all the bold claims made by blood banks, some fucking donor out there just robbed this innocent granny of her life.

samfan · #4 31-12-2006, 08:54 PM

smartalex:

I never claimed knowledge of this or any other cases cited or inferred by you or anyone else.

There is no one who can claim 100% preventative measures or protection against any pathogens. Even a theoretical 1 in a zillion chance will void a 100% claim. So you have a valid point.

BUT I never mentioned 100% in my posts above whatsoever. You quoted me as "is almost totally safe", so there is no argument there that it's not 100%.

I do not posses the so-called "basic training in microbiology" that you mentioned whatsoever howsoever whosoever. As such, I decipher HIV wacko-nuts as they come according to sound medical data and knowledge that is generally accepted by the medical community.

Now try telling me "this has no bearing on HIV transmission from a contaminated donor at all" straight in my eyes. No don't try to dodge my eye contact. If someone can claim that any person could never get infected in a clinical setting from a contaminated donor, ask him to talk to a qualified HIV Specialist. Print 500 copies this posting out and ask the good doctor to smack him on the head with it. Hopefully it will knock some sense into him.

"The greatest contributor to reducing risks today" is not about the accuracy of the tests for crying out loud! It is the better understanding of safer sex practices and the proper understanding of the route of infection that is making this absolutely preventable disease less infectious.

There is no absolutes in this world, even the well-researched and quantified Hepatitis vaccine will not guarantee a 100% prevention from getting infected with Hepatitis.

But if you have to live a life full of anxiety for things that are virtually non-existent or almost totally safe, then you are way too paranoid.

Stop spreading inaccurate information, there is enough chaos in this world to deal with. We don't need another worrisome case in you.

jinrenhe · #5 31-12-2006, 09:17 PM

Quote:

Originally Posted by smartalex

Whatever forms you signed to authorize the blood transfusion and/or surgery has mostly removed your rights to legal action. If you are the unlucky 1 in 225,000 people to get it, it is just bloody damning. That was how I felt seeing the cursed granny in the coffin.

This is so damm scary... i hope it's not another of those internet rumour meant to scare ppl... like one email i received where a person eating raw salmon (shasimi) has worms entering thru the mouth & intto his brainv! But later i realized lotsa of these scary claims are jus rubbish...

I sincerely believe in S'pore at least they wld impose stringent test to ensure the safety... remembered some time ago got this big news about the 5 farkers at risk of HIV donating blood kena arrested...

fulham · #6 31-12-2006, 09:32 PM

Hi, I don't think what you said is true. If you yourself are going for surgery, and due to massive blood loss, doctor will suggest you use your own blood, so you are donating own blood to yourself, let's say 2 bags as storage, they will also test your blood for virus and such, they will inform beforehand your blood will be sent for testing before usage. Even you use for your own self, they will also test it, thats what I am saying, Singapore is very strict.

I believe all blood donors who donate blood, their blood are checked thoroughly before use. If you were to be found to have contaminated blood as a donor and you signed on the form, you will be sent to jail.

If so and so hospital has risk of contaminated blood, i dont think anyone will dare to go there anymore. This type of thing can't be happening in Singapore.

dathinman · #7 31-12-2006, 10:42 PM

Interesting discussion. Got me reading up a bit more. Found this

http://www.fda.gov/cber/faq/bldfaq.htm#gm

However, since 2002, the routine use of nucleic acid testing (NAT) for HIV has even further reduced the risk of transfusion transmission of HIV to about 1 unit per 2 million donations.

Read somewhere else
http://www.thebloodcenter.org/services/nat.html

Unfortunately, there is no test available that can detect viruses immediately after someone has been infected, but NAT has dramatically closed that window. As newer technologies become available, you can be assured that The Blood Center will be at the forefront, increasing the safety of the blood it supplies to the hospitals it serves.

There is still a very, very small risk. In Singapore I think they are using NAT, over here in Malaysia I am not so sure.

By the way the earlier post from samfan was from the AFA website.

http://www.afa.org.sg/aqanda.htm

PS
One paper (published 2000 by SGH doctors) which might interest you
http://jama.highwire.org/cgi/content/abstract/284/2/210

dathinman · #8 31-12-2006, 11:14 PM

jinrenhe,

The risk is very, very small. Don't worry, be happy.

PS
Those links I posted earlier were for the US. Maybe in Singapore, there is even more thorough testing procedures, e.g. testing again after the window period?

fattyboyboy · #9 31-12-2006, 11:35 PM

Hello senior,

Ah Fattyboyboy here.

Sad to hear your granny case.

Since she died of AIDS, I think your friend should ask the hospital to investigate thoroughly.

How she contracted HIV? Not through your friend grand father, how about other sources? Your friend should ask her when she was still around to trace the source of contracting HIV.

samfan · #10 01-01-2007, 12:06 AM

dathinman:

Thanks for highlighting the source of my data. I missed that one out from my post.

In addition, you have touched on an interesting point. Studies conducted by the Red Cross suggests that the window period is reduced by 6 days (from a 22-day window period to a 16-day window period) with the use of the HIV-1 p24 antigen test; HIV-1 NAT has the potential to further reduce the window period by another 5 days.

(http://www.redcross.org/services/bio...y/nucleic.html)

While P-24 Antigen testing is a routine test currently used for detecting HIV in donated blood, the NAT is a potential candidate to further increase the sensitivity of tests, while reducing the detection window period.

fattyboyboy · #11 01-01-2007, 03:32 AM

Quote:

Originally Posted by samfan

dathinman:

Thanks for highlighting the source of my data. I missed that one out from my post.

In addition, you have touched on an interesting point. Studies conducted by the Red Cross suggests that the window period is reduced by 6 days (from a 22-day window period to a 16-day window period) with the use of the HIV-1 p24 antigen test; HIV-1 NAT has the potential to further reduce the window period by another 5 days.

(http://www.redcross.org/services/bio...y/nucleic.html)

While P-24 Antigen testing is a routine test currently used for detecting HIV in donated blood, the NAT is a potential candidate to further increase the sensitivity of tests, while reducing the detection window period.

Hello senior,

Ah Fattyboyboy here.

Thank you for your info

smartalex · #12 01-01-2007, 02:42 PM

Quote:

Originally Posted by samfan

smartalex:
Now try telling me "this has no bearing on HIV transmission from a contaminated donor at all" straight in my eyes. No don't try to dodge my eye contact. If someone can claim that any person could never get infected in a clinical setting from a contaminated donor, ask him to talk to a qualified HIV Specialist.

You don't understand what I'm talking about at all. Pls reread or just forget what I wrote.

Quote:

Originally Posted by samfan

But if you have to live a life full of anxiety for things that are virtually non-existent or almost totally safe, then you are way too paranoid.

Stop spreading inaccurate information, there is enough chaos in this world to deal with. We don't need another worrisome case in you.

I am not living a life of anxiety. Neither do I have any reason to fear because I am not at risk. Everything I wrote is true, factual, and I bear witness to the victim dying in ICU. Her body was too weak at that stage for anti-retrovial therapy to be of any use. So she was just lying there, sub-conscious and waiting to die. L-DOPA was administered since it was end-stage, and she had HIV dementia. Her blood pressure was low, and CO2 build-up was causing acidosis. It was a vicious cycle since the oxygen-CO2 exchange in her lungs was impeded by pneumonia. Over days, her heart weakened to the point it just slowed down, and then it stopped... The poor granny had tears on her eyes, suggesting she didn't want to die.

So, now I know that there is always a tiny possibility of infection where blood transfusion is involved. Yes it is very tiny risk, but since hospital case files are shredded after a patient's discharge, and because it is almost impossible to prove that a certain hospital is responsible, there is almost nothing that the victim and their family can do.

So unless a patient comes into the hospital with a clean blood test, and gets infected with HIV after a procedure - he or she is basically screwed for life. No I am not scaring anyone - just laying out the facts. If you don't find this pleasant, then just please ignore me.

smartalex · #13 01-01-2007, 02:57 PM

Quote:

Originally Posted by fattyboyboy

Hello senior,

Ah Fattyboyboy here.

Sad to hear your granny case.

Since she died of AIDS, I think your friend should ask the hospital to investigate thoroughly.

How she contracted HIV? Not through your friend grand father, how about other sources? Your friend should ask her when she was still around to trace the source of contracting HIV.

The trouble with HIV is the stigma. No sensible children would want people to know that mommy is HIV positive. No point asking the hospital because previous case files are shredded after discharge. Lastly, which doctor in his right mind would want to screw his own career by chasing after the source of contracting HIV?

So we just chant the last rites and hope she gets reincarnated into a more privileged life next round.

fattyboyboy · #14 02-01-2007, 05:54 PM

Quote:

Originally Posted by smartalex

The trouble with HIV is the stigma. No sensible children would want people to know that mommy is HIV positive. No point asking the hospital because previous case files are shredded after discharge. Lastly, which doctor in his right mind would want to screw his own career by chasing after the source of contracting HIV?

So we just chant the last rites and hope she gets reincarnated into a more privileged life next round.

Hello senior,

Ah Fattyboyboy here.

From what you posted so far, I seriously doubt you now.

If she died of AIDS, the death cert will state so. And under the Contagious of Disease Act (I think it is this Act), person died of AIDS, his body must cremated within 24 hrs and there are very strict procedure to follow.

Also she could have contacted HIV via other means. I seriously doubt that she contacted HIV via blood transfusion.

The chances are too remote in SG. Almost negligible!

smartalex · #15 02-01-2007, 10:21 PM

Quote:

Originally Posted by fattyboyboy

Hello senior,

Ah Fattyboyboy here.

From what you posted so far, I seriously doubt you now.

If she died of AIDS, the death cert will state so. And under the Contagious of Disease Act (I think it is this Act), person died of AIDS, his body must cremated within 24 hrs and there are very strict procedure to follow.

Also she could have contacted HIV via other means. I seriously doubt that she contacted HIV via blood transfusion.

The chances are too remote in SG. Almost negligible!

Hi Fattyboyboy,

The granny's HIV status was communicated directly to me by the doctor. You need to differentiate between HIV and AIDS. She died from a lung infection but has yet to develop full-blown AIDS. There is no "Contagious of Disease Act", but there is an "Infectious Diseases Act, Chapter 137", where it says:

Wakes and disposal of corpses
14. —(1) Where any person has died whilst being, or suspected of being, a case or carrier or contact of an infectious disease, the Director may by order —

(a) prohibit the conduct of a wake over the body of that person or impose such conditions as he thinks fit on the conduct of such wake; or

(b) impose such conditions as he thinks fit for the collection, removal and disposal of the body of that person.

There is no compulsory 24hr cremation rule, but it is on a case-by-case basis. So you are the one who don't know what you are talking about. I don't know what your job is, but it seems you are eager to make it clear that HIV from local hospitals is remote.

My job is to highlight that it has happened, even though it is remote. Your team can come out to discredit me all you like, but hey it has happened to someone close to me. I am not sure if you have been through this nonsense in your life to feel my sense of indignation, but nobody ever claimed that blood transfusion was 100% risk-free, even in Singapore.

Anyway all this talk is a waste of time. We will never have HIV infection statistics from the hospitals, so only those who have been through this will know what's going on.

In the mean time, if what I said is not making sense, then please skip it and carry on with your lives. It is probably too remote a possibility to happen to random readers out there.