Transfusion-related human immunodeficiency virus in patients with haemophilia in Johannesburg

Tests were carried out on 198 patients with inherited coagulation disorders attending haemophilia clinics of Johannesburg and Baragwanath Hospitals for the prevalence of antibodies to the human immunodeficiency virus (HIV). This cohort of patients has been treated with locally produced (South African) blood products from volunteer donors, except for a 15-month period in 1982-1984 when, owing to a shortage of locally produced material, an imported large donor-pool US factor VIII concentrate was used. Not all patients received this material. Of the haemophilia A patients who received the imported factor VIII concentrate, 85% were seropositive, while only 3% of the patients who received locally produced small donor-pool products were seropositive. No factor VIII-deficient patients have seroconverted while using small donor-pool products, since the introduction of routine screening of blood donations and strict exclusion criteria of donors. However, despite testing of blood products, 3 patients receiving locally produced factor IX concentrate (4,000 donors) seroconverted in 1988, having previously been HIV-negative. Factors influencing the choice of blood products to be used, especially in South Africa, are discussed.