Acquired Immunodeficiency Syndrome (AIDS) Associated with Transfusions

Curran, James W.; Lawrence, Dale N.; Jaffe, Harold W.; Kaplan, Jonathan E.; Zyla, Lawrence D.; Chamberland, Mary E.; Weinstein, Robert S.; Lui, Kung‐Jong; Schonberger, Lawrence B.; Spira, Thomas J.; Alexander, W. James; Swinger, Gary; Ammann, Arthur J.; Solomon, Steven L.; Auerbach, David M.; Mildvan, Donna; Stoneburner, Rand; Jason, Janine; Haverkos, Harry W.; Evatt, Bruce L.

doi:10.1056/nejm198401123100201

Cited by 547 publications

(88 citation statements)

References 14 publications

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“…Transfusion-associated acquired immunodeficiency syndrome (AIDS) provides a unique opportunity to study the incubation period ofthis disease because the date ofexposure to the virus can be accurately determined through epidemiologic investigations that identify which blood donor, and donation date, was associated with transmission of infection (1). We define the incubation period as the period from transfusion to the diagnosis of the first opportunistic disease associated with AIDS.…”

mentioning

confidence: 99%

A model-based approach for estimating the mean incubation period of transfusion-associated acquired immunodeficiency syndrome.

Lui¹,

Lawrence²,

Morgan³

et al. 1986

Proc. Natl. Acad. Sci. U.S.A.

170

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The incubation period, representing the interval between the date of exposure and the date of diagnosis, can be firmly ascertained in transfusion-associated cases of acquired immunodeficiency syndrome (AIDS). However, because the observation period of all transfusion-infected persons may be short compared with the average incubation period for AIDS, many cases with long incubation periods have not yet been diagnosed. Thus, the simple average of 2.6 years tends to underestimate the true mean. To correct for this underestimation bias, we assumed that the underlying distribution of the incubation periods is a member of a broad class of probability densities. Then, by maximum likelihood techniques, the mean incubation period for transfusion-associated AIDS was estimated to be 4.5 years, with the 90% confidence interval ranging from 2.6 to 14.2 years. The logng incubation period has important consequences for infected individuals and implications for public health intervention and prevention policy.Transfusion-associated acquired immunodeficiency syndrome (AIDS) provides a unique opportunity to study the incubation period ofthis disease because the date ofexposure to the virus can be accurately determined through epidemiologic investigations that identify which blood donor, and donation date, was associated with transmission of infection (1). We define the incubation period as the period from transfusion to the diagnosis of the first opportunistic disease associated with AIDS. The date of diagnosis is used as a closure for this period, rather than the more conventional date ofonset of symptoms, because the earliest symptoms are typically nonspecific and their dates of onset are poorly remembered.During the initial phase of a new disease epidemic, use of the simple average of the incubation periods of the observed cases is subject to two types of bias due to length-biased sampling. One bias can result from any omission of patients who had such short incubation periods that their illnesses went undiagnosed as AIDS before the existence of transfusion-associated AIDS was first recognized; this constitutes left censoring in our sample. As a consequence of this bias, the traditional estimate, the mean incubation periods of the observed cases, might tend to overestimate the true mean. On the other hand, another source of bias can arise from the fact that our sample does not include those exposed persons who will have such long incubation periods that they have not yet been diagnosed; this constitutes right censoring, which might cause the traditional estimate to underestimate the true mean.Our estimate would now suggest that the right censoring exerts a greater impact on the estimate and the simple average tends to represent an underestimation. Moreover, immediately following a period when the rate of exposure is increasing, as certainly was occurring with AIDS during 1978-1984, the degree of underestimation due to the right censoring is even greater, since the absolute number of patients with short incubation perio...

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mentioning

confidence: 99%

A model-based approach for estimating the mean incubation period of transfusion-associated acquired immunodeficiency syndrome.

Lui¹,

Lawrence²,

Morgan³

et al. 1986

Proc. Natl. Acad. Sci. U.S.A.

170

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“…2 In fact, it is not yet known at which stage the disorder may be most communicable. Hepatitis B, the disease which epidemiological^ appears most similar to AIDS, clearly may be transmitted by an asymptomatic individual.…”

Section: Aids Precautions For Other High-risk Groups?mentioning

confidence: 99%

AIDS Precautions for Other High-Risk Groups?

Klein

Friedland

1984

Infect. Control

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“…Similar charges that donors and blood banks spread hepatitis B had been made earlier, but these legal suits were rarely successful (79,96). Yet with AIDS, a similar situation, a surprisingly large number of suits were filed by PWA or their estates (3,9,55). Many complaints were filed after 1985, when the means to detect HIV presence in transfusion blood became available (28).…”

Section: Introductionmentioning

confidence: 99%

Acquired immunodeficiency syndrome: More than a health-related dilemma

Severin¹

1990

Health Policy

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Acquired Immunodeficiency Syndrome (AIDS) Associated with Transfusions

Cited by 547 publications

References 14 publications

A model-based approach for estimating the mean incubation period of transfusion-associated acquired immunodeficiency syndrome.

A model-based approach for estimating the mean incubation period of transfusion-associated acquired immunodeficiency syndrome.

AIDS Precautions for Other High-Risk Groups?

Acquired immunodeficiency syndrome: More than a health-related dilemma

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