Paragraph In December 1982, a report in the Morbidity and Mortality Weekly Repor
ID: 146146 • Letter: P
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Paragraph In December 1982, a report in the Morbidity and Mortality Weekly Report (MMWR) described three persons who had developed acquired immunodeficiency syndrome (AIDS) but who had neither of the previously known risk factors for the disease: homosexual/bisexual activity with numerous partners and intravenous drug use. These three persons had previously received whole- blood transfusions. By 1983, widespread recognition of the problem of transfusion-related AIDS led to controversial recommendations that persons in known high-risk groups voluntarily defer from donating blood. In June 1984, after the discovery of the human immunodeficiency virus (HIV), five companies were licensed to produce enzyme-linked immunosorbent asay (EIA, then called ELISA) test kits for detecting HIV antibody. A Food and Drug Administration (FDA) spokesman stated that, "..getting this test out to the blood banks is our No. 1 priority.. , Blood bank directors were anxiously waiting to start screening blood with the new test until March 2, 1985, the date the first test kit was approved by the FDA In the pre-licensure evaluation, sensitivity and specificity of the test kits were estimated using blood samples from four groups: those with AIDS by CDC criteria, those with other symptoms and signs of HIV infection, those with various autoimmune disorders and neoplastic diseases that could give a false-positive test result, and presumably healthy blood and plasma donors. Numerous complex issues were discussed even before licensure. Among them were understanding the magnitude of the problem of false-positive test results and determining whether test-positive blood donors should be notified It is now March 2, 1985. The first HIV antibody test kits will arrive in blood banks in the state in a few hours. Meeting with YOU to discuss the appropriate use of this test are the Commissioner of Health, the medical director of the regional blood bank, and the chief of the State Drug Abuse Commission Pre-lab Questions: Answer the following questions on a sheet of paper. They will be collected with the in-class lab assignment. 1. (2 points) Keeping in mind that this case study is taking place in 1985, discuss any potential pros/cons of the following situations a. Being identified as having HIV when a person actually has the disease b. Being identified as having HIV when a person doesn't have the disease. c. Not being identified as having HIV when a person has the disease. d. Not being identified as having HIV when a person doesn't have the disease 2. (1 point) Explain the importance of detecting HIV in blood donated to a blood bank a. What are the consequences for not detecting the virus when it is present? b. What are the consequences for incorrectly detecting the virus when it is not present? (1 point) Explain the importance of detecting HIV in individuals who use intravenous- drugs 3. What are the consequences for not detecting the virus when it is present? What are the consequences for incorrectly detecting the virus when it is not present? a. b.Explanation / Answer
1) a) When the person is being identified as having HIV when a person actually has the disease is the desired result of any screening test. This will help the person to take measures to prevent further damage and to prevent the spread of disease to the healthy person.
b) Being identified as HIV, when the person does not have the disease signifies false positive results. This results in unwanted panic and create psychological upset affecting the quality of life.
c) Not being identified as having HIV, when a person has the disease signifies false negatives. They have false hope of being healthy and also they will spread the disease to others. Further, early treatment for the disease cannot be initiated.
d) Not being identified as HIV when the person doesn't have the disease signifies true negatives. This condition is ideal. The person will be declared healthy and can lead a normal life.
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