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Decreased risk for the acquisition of human immunodeficiency virus (HIV) infection in hemo-dialysis patients in Rio de Janeiro State, Brazil

The initial surveys on the seroprevalence of anti-HIV-1 antibodies (HIV-Ab) in hemodialysis units in the State of Rio de Janeiro (RJ) were done in 1985. The alarming figures around 15% were ascribed to the poor quality of blood collected from "professional donors" in exchange for food or money. Recently a concerted effort has been launched to curtail the blood trade. We decided to investigate whether these measures have produced any impact on HIV-Ab seroprevalence in two satellite units in RJ. Segumed was among the units studied in 1985. We conducted another survey in 1987 on the same patients previously studied. CS Grajaú, a new unit where most of the patients were new on dialysis, was studied in 1988. A HIV-1 ELISA was used as screening. Positive results were confirmed by Western blot. Results in Segumed showed a marked difference in seroprevalence of HIV-Ab (14.4% vs 3.6%). The two cases identified in 1987 were among the ones identified in 1985. No patient became infected between the two surveys despite the lack of isolation of HIV carriers and the increase in blood use during the period. In CS Grajaú two cases were found (2.4% prevalence) but one of them was known since 1985 when living with a transplant. A review of all similar reports from RJ area suggest a trend towards lower figures in recent years. We conclude that the chance of acquiring HIV infection is currently low in the centers studied and may be falling in RJ. It is possible that the increased surveillance and even closure of blood banks has resulted in an improvement of the quality of blood available for transfusion in RJ.

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