Epidemiology of transfusion-associated acquired immunodeficiency syndrome in children in the United States: 1981 through 1989

From 1981 through 1989, 212 cases of transfusion-associated (TA) acquired immunodeficiency syndrome (AIDS) were reported to the Centers for Disease Control. In a study of the epidemiology of pediatric TA AIDS, this group was compared with perinatally acquired (PA) and adult TA AIDS cases. The number of pediatric TA AIDS cases reported each year began to stabilize in 1988 and declined 41% in 1989. Reported adult TA AIDS cases continued to increase by 33% in 1988 and declined by 15% in 1989. The number of reported PA cases has continued to increase each year. Seventy percent of the children with TA AIDS were transfused in their first year of life. The median age at diagnosis was 4 years (range 0.3 to 12.8 years) compared with a median age at diagnosis of 1 year (range 0.1 to 12.9 years) in the PA cases. Using a nonparametric estimation procedure for truncated data, the estimated incubation period from time of infection to diagnosis of AIDS was longer for pediatric TA AIDS cases than PA cases (median, 3.5 years vs 1.75 years) but shorter than for adult TA cases (median, 4.5 years). The median survival after diagnosis of TA AIDS in children did not differ from that in PA cases (13.7 vs 14.3 months) but was longer than in adult TA cases (5.6 months P less than .01). The decline in the reported incidence of pediatric and adult TA AIDS cases reflects the effects of donor deferral and donor screening for human immunodeficiency virus infection.