Transmission of Human Immunodeficiency Virus and Hepatitis C Virus From an Organ Donor to Four Transplant Recipients

Authors

  • M. G. Ison,

    1. Division of Infectious Diseases
    2. Division of Organ Transplantation, Northwestern University Feinberg School of Medicine, Chicago, IL
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  • E. Llata,

    1. Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA
    2. Epidemic Intelligence Service, Office of Workforce and Career Development, Centers for Disease Control and Prevention, Atlanta, GA
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  • C. S. Conover,

    1. Laboratory Branch, Division of HIV/AIDS Prevention, Division of Infectious Diseases, Illinois Department of Public Health, Springfield, IL
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  • J. J. Friedewald,

    1. Division of Organ Transplantation, Northwestern University Feinberg School of Medicine, Chicago, IL
    2. Division of Nephrology/Hypertension, Northwestern University Feinberg School of Medicine, Chicago, IL
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  • S. I. Gerber,

    1. Cook County Department of Public Health, Chicago, IL
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  • A. Grigoryan,

    1. Epidemic Intelligence Service, Office of Workforce and Career Development, Centers for Disease Control and Prevention, Atlanta, GA
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  • W. Heneine,

    1. Laboratory Branch, Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA
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  • J. M. Millis,

    1. Section of Transplantation, University of Chicago, Chicago, IL
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  • D. M. Simon,

    1. Section of Infectious Diseases, Rush University Medical Center, Chicago, IL
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  • C.-G. Teo,

    1. Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA
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  • M. J. Kuehnert,

    Corresponding author
    1. Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA
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  • and the HIV-HCV Transplantation Transmission Investigation Team

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    • The HIV-HCV Transplantation Transmission Investigation Team. Centers for Disease Control and Prevention: S. Ramachandran, D. Seem, J. Drobeniuc, T. Durant, J. Easton, L. Ganova-Raeva, G. Garcia-Lerma, S. Holmberg, Y. Khudyakov, L. Kumar, Y. Lin, M. Millis, B. Minske, S. Owen, J. Ponterelli, K. Sullivan, W. M. Switzer, A. S. Youngpairoj and G. L. Xia; Gift of Hope Organ and Tissue Donor Network: M. Mozes and A. Smith; Northwestern University Feinberg School of Medicine: E. DeMayo and V. Stosor; Rush University Medical Center: S. Forrest Dodson; University of Chicago Medical Center: E. A. King.


Corresponding author: Matthew J. Kuehnert, mgk8@cdc.gov

Abstract

In 2007, a previously uninfected kidney transplant recipient tested positive for human immunodeficiency virus type 1 (HIV) and hepatitis C virus (HCV) infection. Clinical information of the organ donor and the recipients was collected by medical record review. Sera from recipients and donor were tested for serologic and nucleic acid-based markers of HIV and HCV infection, and isolates were compared for genetic relatedness. Routine donor serologic screening for HIV and HCV infection was negative; the donor's only known risk factor for HIV was having sex with another man. Four organs (two kidneys, liver and heart) were transplanted to four recipients. Nucleic acid testing (NAT) of donor sera and posttransplant sera from all recipients were positive for HIV and HCV. HIV nucleotide sequences were indistinguishable between the donor and four recipients, and HCV subgenomic sequences clustered closely together. Two patients subsequently died and the transplanted organs failed in the other two patients. This is the first recognized cotransmission of HIV and HCV from an organ donor to transplant recipients. Routine posttransplant HIV and HCV serological testing and NAT of recipients of organs from donors with suspected risk factors should be considered as routine practice.

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