During the HIV epidemic in the 1980s, more than half of the hemophiliac patients living in many countries, including the United States, France, Denmark, and Japan, became infected with HIV as a result of blood transfusions with contaminated blood or blood products.[1,2] Since the clotting factor needed to treat hemophiliacs was manufactured by pooling plasma from thousands of donors, even one HIV-infected donor could contaminate the entire supply, infecting hundreds.
Several developed countries faced civil litigation that resulted in the indictment and imprisonment of government officials and industry leaders for their role in the mismanagement of the blood supply. Investigations of these individuals revealed that they delayed the implementation of donor screening policies and/or technologies used to screen donors and blood supplies for HIV.
Fear of future litigation combined with the development and implementation of blood donor screening policies and screening tests in the last 17 years have helped to ensure the safety of the blood supply in developed countries. Many developing countries, however, have been struggling to adopt similar safety measures.
Most developing countries cannot afford, nor do they have the infrastructure required, to implement the effective yet costly methods to ensure safety employed in developed countries. Some 13 million units, or up to 45% of blood donations in developing countries, are never tested for infections transmissible by transfusion.[3,4]
In addition, donors in developing countries are often compensated monetarily, attracting people living in poverty who have a high risk of carrying HIV, hepatitis C virus, or hepatitis B virus. These people often donate frequently without regard to the status of their health and the risk to others.
Thus, 10% of new HIV infections in developing countries are estimated to result from transfusions using infected blood and blood products.