Utahns receive 100,000 transfusions of blood or blood components each year. What are their chances of getting AIDS or hepatitis from the state's blood supply?
About nil, according to Dr. Myron Laub, medical director of Intermountain Health Care Blood Services, which supplies most of Utah's major hospitals.Laub reports that a person's chance of getting infected with the AIDS virus from a unit of transfused blood is about one in a million in Utah - compared with about one in 100,000 nationally.
By contrast, the average person's chance of getting killed in an auto accident in a year is about one in 5,000.
The risk of transfusion hepatitis, on the other hand, is much higher. Despite new testing, some experts believe the national risk is one in 20. In Utah, it's one in 10,000.
Despite past foot-dragging, the blood-banking industry is making strides in protecting the blood supply. Laub said the first precaution is that donors are asked not to give blood if they have been exposed to infectious diseases, such as malaria, hepatitis or AIDS, or if they are in a high-risk category for AIDS.
The second line of defense is laboratory testing. Called ELISA (for enzyme-linked immunosorbent assay), the test does not reveal the AIDS virus itself, but the antibodies that form in response to it.
Laub said the problem is that the immune system usually takes three months to produce detectable numbers of these antibodies. The blood of an infected person can slip through if they are in this stage.
That's why IHC has a third protection. Donors are asked confidentially if they believe their blood is safe for others to receive. "If they mark that it's not safe, we don't use it regardless if it tests safe or not," Laub said.
Researchers are looking for better ways to screen blood. But Laub said even if a foolproof AIDS test for HIV (human immunodeficiency virus) is developed, it's likely that new viruses will take its place, such as HIV-2, which causes an AIDS-like disease, or HTLV-1 (human T-cell lymphotropic virus), which causes a devastating form of adult T-cell lymphoma-leukemia and a nerve disorder resembling multiple sclerosis.
Then there's hepatitis. Experiments suggest that virtually everyone given blood tainted with NANB (Non-A, Non-B) hepatitis becomes infected.
Laub said only seven or eight Utahns a year get infected, and an estimated 25 percent to 30 percent of them develop a chronic illness. The NANB hepatitis screening tests have cut local incidences by 50 percent.
What can be done to beat the odds? Specialists list a few options:
* "Artificial blood." Researchers are experimenting with the development of chemically modified hemoglobin, the oxygen-carrying protein in blood. In animal experiments, this chemical solution delivers oxygen as well as natural blood. But Laub says it's not available for human use. Plus, it doesn't meet any coagulation factors or stop the bleeding problem.
* Blood salvage. Blood lost during surgery is pumped into a machine that separates out the red cells, washes them and reinfuses them into the patient. A number of large Utah hospitals have been using this procedure for years.
* Self-donation. Laub said storing your own blood is the surest way to eliminate risk. Because you can donate up to a pint of blood a week under optimal conditions, and red cells keep for up to six weeks, you can store about five units before some surgeries. IHC Blood Services had been using this procedure long before the AIDS virus was ever identified.
* Designated donation. This involves simply asking friends and relatives to donate - a procedure IHC Blood Services highly discourages because there is no evidence the blood is safer. In fact, IHC has found a higher incidence of disease among first-time donors.
"Our average donor gives up to three times a year and has been tested each time - over and over again through the years," said Laub, who's only seen two cases of contaminated blood. And in both cases the potential donors used the "confidential exclusion" method to tell IHC the blood wasn't safe.
"As long as we have good healthy people who know they are clean donating blood, then we don't have to worry," he stressed. "We would encourage those people who know they are clean to give blood so we don't have to get blood from other states where the risks are higher or pay for blood which would give people a reason to lie about their eligibility."