Skip to main content
PMC home page
American Journal of Public Health logoLink to American Journal of Public Health
. 1988 Apr;78(4):450–454. doi: 10.2105/ajph.78.4.450

Screening blood donors for human immunodeficiency virus antibody: cost-benefit analysis.

R S Eisenstaedt 1, T E Getzen 1
PMCID: PMC1349374  PMID: 3126676

Abstract

The costs and benefits of screening blood donors for antibody to human immunodeficiency virus (HIV) are assessed. Total costs, including testing, discarding processed blood, marginal donor recruiting, notifying and evaluating positive donors, are $36,234,000 annually for 10 million donors in 1986. Screening these donors will prevent 292 cases of transfusion-transmitted acquired immune deficiency syndrome (TT-AIDS), saving the costs of therapy and loss of earnings for total benefits of $43,490,480, a benefit:cost ratio of 1.2:1. Net economic benefits of $0.73 per donor will arise from the program. Calculated benefits will rise as increased numbers of infected recipients are diagnosed with longer follow-up or as partially effective therapy increases the cost of caring for patients with AIDS. Changes in test sensitivity, follow-up procedures, estimated value of life, and testing costs will also alter these projections, but none as dramatically as a change in the overall specificity of the screening process. The cost per case of TT-AIDS prevented, $124,089, and cost per year of life extended, $10,885, are comparable to costs of other screening programs.

Full text

PDF
450

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aach R. D., Szmuness W., Mosley J. W., Hollinger F. B., Kahn R. A., Stevens C. E., Edwards V. M., Werch J. Serum alanine aminotransferase of donors in relation to the risk of non-A,non-B hepatitis in recipients: the transfusion-transmitted viruses study. N Engl J Med. 1981 Apr 23;304(17):989–994. doi: 10.1056/NEJM198104233041701. [DOI] [PubMed] [Google Scholar]
  2. Berwick D. M., Cretin S., Keeler E. Cholesterol, children, and heart disease: an analysis of alternatives. Pediatrics. 1981 Nov;68(5):721–730. [PubMed] [Google Scholar]
  3. Centers for Disease Control (CDC) Transfusion-associated human T-lymphotropic virus type III/lymphadenopathy-associated virus infection from a seronegative donor--Colorado. MMWR Morb Mortal Wkly Rep. 1986 Jun 20;35(24):389–391. [PubMed] [Google Scholar]
  4. Curran W. J. AIDS research and "the window of opportunity". N Engl J Med. 1985 Apr 4;312(14):903–904. doi: 10.1056/NEJM198504043121407. [DOI] [PubMed] [Google Scholar]
  5. Feorino P. M., Jaffe H. W., Palmer E., Peterman T. A., Francis D. P., Kalyanaraman V. S., Weinstein R. A., Stoneburner R. L., Alexander W. J., Raevsky C. Transfusion-associated acquired immunodeficiency syndrome. Evidence for persistent infection in blood donors. N Engl J Med. 1985 May 16;312(20):1293–1296. doi: 10.1056/NEJM198505163122005. [DOI] [PubMed] [Google Scholar]
  6. Fischl M. A., Richman D. D., Grieco M. H., Gottlieb M. S., Volberding P. A., Laskin O. L., Leedom J. M., Groopman J. E., Mildvan D., Schooley R. T. The efficacy of azidothymidine (AZT) in the treatment of patients with AIDS and AIDS-related complex. A double-blind, placebo-controlled trial. N Engl J Med. 1987 Jul 23;317(4):185–191. doi: 10.1056/NEJM198707233170401. [DOI] [PubMed] [Google Scholar]
  7. Goldsmith M. F. HTLV-III testing of donor blood imminent; complex issues remain. JAMA. 1985 Jan 11;253(2):173-5, 179-81. doi: 10.1001/jama.253.2.173. [DOI] [PubMed] [Google Scholar]
  8. Hardy A. M., Allen J. R., Morgan W. M., Curran J. W. The incidence rate of acquired immunodeficiency syndrome in selected populations. JAMA. 1985 Jan 11;253(2):215–220. [PubMed] [Google Scholar]
  9. Hardy A. M., Rauch K., Echenberg D., Morgan W. M., Curran J. W. The economic impact of the first 10,000 cases of acquired immunodeficiency syndrome in the United States. JAMA. 1986 Jan 10;255(2):209–211. [PubMed] [Google Scholar]
  10. Hornbrook M. C., Dodd R. Y., Jacobs P., Friedman L. I., Sherman K. E. Reducing the incidence of non-A, non-B post-transfusion hepatitis by testing donor blood for alanine aminotransferase: economic considerations. N Engl J Med. 1982 Nov 18;307(21):1315–1321. doi: 10.1056/NEJM198211183072105. [DOI] [PubMed] [Google Scholar]
  11. Landefeld J. S., Seskin E. P. The economic value of life: linking theory to practice. Am J Public Health. 1982 Jun;72(6):555–566. doi: 10.2105/ajph.72.6.555. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Lui K. J., Lawrence D. N., Morgan W. M., Peterman T. A., Haverkos H. W., Bregman D. J. A model-based approach for estimating the mean incubation period of transfusion-associated acquired immunodeficiency syndrome. Proc Natl Acad Sci U S A. 1986 May;83(10):3051–3055. doi: 10.1073/pnas.83.10.3051. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Mayer K. H., Stoddard A. M., McCusker J., Ayotte D., Ferriani R., Groopman J. E. Human T-lymphotropic virus type III in high-risk, antibody-negative homosexual men. Ann Intern Med. 1986 Feb;104(2):194–196. doi: 10.7326/0003-4819-104-2-194. [DOI] [PubMed] [Google Scholar]
  14. McNeil B. J., Eddy D. M. The costs and effects of screening for cancer among asbestos-exposed workers. J Chronic Dis. 1982;35(5):351–358. doi: 10.1016/0021-9681(82)90006-6. [DOI] [PubMed] [Google Scholar]
  15. Peterman T. A., Jaffe H. W., Feorino P. M., Getchell J. P., Warfield D. T., Haverkos H. W., Stoneburner R. L., Curran J. W. Transfusion-associated acquired immunodeficiency syndrome in the United States. JAMA. 1985 Nov 22;254(20):2913–2917. [PubMed] [Google Scholar]
  16. Ranki A., Valle S. L., Krohn M., Antonen J., Allain J. P., Leuther M., Franchini G., Krohn K. Long latency precedes overt seroconversion in sexually transmitted human-immunodeficiency-virus infection. Lancet. 1987 Sep 12;2(8559):589–593. doi: 10.1016/s0140-6736(87)92985-0. [DOI] [PubMed] [Google Scholar]
  17. Salahuddin S. Z., Groopman J. E., Markham P. D., Sarngadharan M. G., Redfield R. R., McLane M. F., Essex M., Sliski A., Gallo R. C. HTLV-III in symptom-free seronegative persons. Lancet. 1984 Dec 22;2(8417-8418):1418–1420. doi: 10.1016/s0140-6736(84)91619-2. [DOI] [PubMed] [Google Scholar]
  18. Schorr J. B., Berkowitz A., Cumming P. D., Katz A. J., Sandler S. G. Prevalence of HTLV-III antibody in American blood donors. N Engl J Med. 1985 Aug 8;313(6):384–385. doi: 10.1056/NEJM198508083130610. [DOI] [PubMed] [Google Scholar]
  19. Scitovsky A. A., Cline M., Lee P. R. Medical care costs of patients with AIDS in San Francisco. JAMA. 1986 Dec 12;256(22):3103–3106. [PubMed] [Google Scholar]
  20. Scitovsky A. A., Rice D. P. Estimates of the direct and indirect costs of acquired immunodeficiency syndrome in the United States, 1985, 1986, and 1991. Public Health Rep. 1987 Jan-Feb;102(1):5–17. [PMC free article] [PubMed] [Google Scholar]
  21. Seage G. R., 3rd, Landers S., Barry A., Groopman J., Lamb G. A., Epstein A. M. Medical care costs of AIDS in Massachusetts. JAMA. 1986 Dec 12;256(22):3107–3109. [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES