Eighteen-year follow-up report of the surveillance and prevention of an HIV/AIDS outbreak amongst plasma donors in Hebei Province, China

Suliang Chen, Hongru Zhao, Cuiying Zhao, Yuqi Zhang, Baojun Li, Guangyi Bai, Liang Liang, Xinli Lu

There has been a clear increase in HIV-1 infection cases in recent years in Hebei Province, China, and transmission via blood is one of the risk factors in the early. This article aimed to investigate the HIV infection rate and control efficiency among the paid blood donor population over a period of 18 years. From 1995-2013, HIV/AIDS cases among former blood donors in Hebei Province were registered and closely monitored to collect data of all-cause mortality, intervention measures to prevent family transmission, disease transmission between couples as well as between mothers and infants, and HAART therapy outcomes. A total of 326 cases were identified as directly infected with HIV/AIDS during plasma donation in Hebei Province. Of these, 146 cases (44.8 %) were identified in the same year as infection; 180 cases (55.2 %) were identified 1-18 years after infection because they did not participate in the 1995 screening. The final case was identified in February 2012. By 2013, the mortality rate and survival rate of plasma donor-related HIV/AIDS was 54.9 % and 45.1 %, respectively. The identified transmission rate between couples was 11.3 % (8/71); this rate during the same year as infection was 3.3 % (1/30), and the rate 4-17 years after HIV infection was 17.1 % (7/41). Approximately 91.2 % (145/159) of married women of childbearing age did not have children after being informed of HIV infection. Only 8.8 % (14/159) of these women had children after being informed of HIV infection. The mother-to-infant transmission rate was 38.5 % (5/13). The HAART coverage rate has increased from 10.1 % (16/159) in 2003 to 83.6 % (127/152) in 2013. Since 1999, the HIV mortality rate has trended up; by 2013, the cumulative mortality rate reached 54.9 % (179/326). After HAART was initiated in China, the death rate decreased to some extent. Second generation transmission (via couple or mother-to-infant transmission) among blood donor-related HIV cases accounted for approximately 4.0 % (13/326). All first- or second-generation cases were infected with HIV-1 subtype B. In this accident of HIV-infection among plasma donors in Hebei Province, a total of 339 direct and second-generation cases have been identified over 18 years of monitoring. Favorable clinical results have been achieved using intervention measurements and antiviral therapy.