Insidious Killer


The death of two organ transplant recipients from AIDS is a clear reminder of the insidious nature of this human immunodeficiency virus. The donor, a 22-year-old Virginia man, was shot to death during a robbery in 1985. Doctors who recommended using his organs to help other people live had no way of knowing the murder victim had contracted AIDS, because his tissues reportedly tested negative for the virus.

That didn't tell the whole story, it turns out. The man apparently contracted the disease shortly before he was killed. Widely used tests for AIDS look for antibodies, which show that a person has been exposed to the virus, rather than the virus itself, so a recent infection could easily have been missed. As a result, a heart-transplant patient and a kidney recipient are dead despite the best efforts of their doctors, and a third victim, a bone-marrow recipient, now tests positive for the disease.

Medical authorities say most of the murder victim's body parts were treated with alcohol, which can kill the virus, or irradiated before being shipped to some 30 hospitals. But HIV, a trickster under ordinary circumstances, has demonstrated chilling abilities to hide in cells not originally thought to be susceptible to its attack and to camouflage its genetic makeup to confuse immune-system responses. Too much alcohol or irradiation would destroy the tissues being transplanted, leaving open the possibility that HIV could also survive in still more hiding places. In any case, certain body parts, including bone marrow, soft tissues and the pancreas, would not have been treated. So 53 organ and tissue recipients, whose lives were already at risk, now face even greater jeopardy.

As if that were not enough, the AIDS death of a Maryland dentist who treated thousands of penitentiary inmates is a new scare for Maryland. A recent Centers for Disease Control report said up to 100 Americans contracted AIDS infections during medical or dental treatment in the past decade. The number is small, but the unsureness it causes is great among patients.

What is sure is that despite the progress science has made decoding AIDS' deadly instructions to the immune system, an answer to the worldwide epidemic is not yet on the horizon. That means medical personnel, especially those in areas that could provide routes of infection such as blood banks, transplant centers and operating rooms generally, cannot relax their vigilance. It also means that only through increased awareness of the ways to protect against this disease can the public be safeguarded. Many new treatments have been developed to prolong the lives of victims of this disease, but the best treatment of all is prevention of infection.

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