Which of the following statements regarding the transmission of infectious agents through blood transfusions is/are true?

A. The transmission rates for human immunodeficiency virus (HIV) have been decreasing progressively since the early 1980s.

B. The transmission rates of hepatitis have been decreasing steadily since the 1980s.

C. Cytomegalovirus (CMV) is the infectious agent most commonly transmitted in blood

D. Severely immunocompromised patients (such as patients undergoing transplantation) should receive specially screened blood products.

DISCUSSION: The incidence of both HIV and hepatitis transmitted via blood transfusions has been steadily decreasing since the 1980s. This is related to improved methods for detection and increased awareness of surrogate markers of disease. The currently available techniques for the detection of HIV are highly effective, provided the donor is not in the “window” before the formation of specific antibody. The surrogate markers for hepatitis C, as well as the specific assays for the organism, are now sufficiently refined to allow the detection of a large percentage of hepatitis C infection in donated blood. Screening for hepatitis B surface antigen has effectively eliminated the transmission of hepatitis B through blood products in most cases. CMV is the most commonly transmitted infectious agent in blood. Since a large percentage of the population carry the virus, routine screening is not performed for this organism; however, severely compromised patients such as those undergoing transplantation should receive CMV-negative blood products.