Renal cell carcinoma: blood transfusion and survival.

Abstract

AIDS virus antibody in polytransfused dialysis patients vaccinated against hepatitis BPatients receiving long term haemodialysis are at increased risk of hepatitis B infection.Given the similar transmission routes of hepatitis B virus and the virus of the acquired immune deficiency syndrome (AIDS) it is surprising that no seroprevalence data on infection with lymphadenopathy associated virus/human T cell lymphotropic virus type III (LAV/HTLV-III) in dialysis centres have been published.We present data from 18 haemodialysis centres in Belgium, where we surveyed all patients who had received at least three doses of hepatitis B vaccine.These centres had had a high incidence of hepatitis B infection before vaccination. Patients, methods, and resultsAt the end of 1985 serum samples were obtained from 729 patients receiving haemodialysis (335 (46%) men, 394 (54%) women).These patients received three to nine (mean 4-2) doses of plasma derived hepatitis B vaccine, some beginning in 1981.'They had been dialysed in 18 centres in Belgium for an average of 37 months.Pasteur vaccine (six lots) had been given to 488 patients (67%); CLB (Centraal Laboratorium voor de Bloedtransfusie, Dutch Red Cross) vaccine (two lots) to 146 (20%); MSD (Merck Sharp and Dohme) vaccine (one lot) to 29 (4%); and an assortment of the above vaccines to the others.About 90% of patients had received blood transfusions.In 1981, 46% of patients were transfused over six months,' and this practice had essentially been maintained.Screening for anti-LAV/HTLV-III by the Abbott enzyme linked immunosor- bent assay gave a positive finding in 33 patients (4 5%) and the result remained positive on repeat testing in 17 (2 * 3%).In no case detected by screening could the result be confirmed by immunofluorescence, Western blot, or the Wellcome competitive enzyme linked immunosorbent assay, and results were also negative with the new Abbott recombinant envelope/core competitive confirmatory enzyme linked immunosorbent assay.Most false positive results could be explained by cross reactivity in the Abbott screening assay of antibody against lymphocyte (HLA) components elicited by transfusion.2