HIV Outbreaks Linked to Blood Transfusions Discovered in Central Asia Since Kazakh Doctors Were Convicted of Criminal Negligence

Outbreaks of HIV linked to blood transfusions have occurred throughout Central Asia since an outbreak of the virus was discovered at a children's hospital in Shymkent, Kazakhstan, the Chicago Tribune reports (Rodriguez, Chicago Tribune, 9/16).

Twenty-one health workers and health officials in Shymkent were put on trial for medical malpractice following the HIV outbreak. A medical investigation conducted by CDC identified transfusions of tainted blood as the source of the Shymkent HIV outbreak. Since summer 2006, 118 children who received blood transfusions at the hospital have tested positive for HIV. Ten of the children have died from AIDS-related illnesses. Seventeen health workers in Shymkent in June were sentenced to prison after being convicted of criminal negligence following the outbreak (Kaiser Daily HIV/AIDS Report, 6/28).

Attorneys for the convicted doctors claimed that the children contracted HIV through mother-to-child transmission. However, the women were tested and found to be HIV-negative, Katira Bekbolova, a lawyer for the parents of the HIV-positive children, said. According to court records, officials tried to cover up the outbreak. A court-ordered evaluation of supplies and procedures at the hospitals found that syringes and catheters routinely were reused and that the hospitals did not have an adequate supply of catheters (Chicago Tribune, 9/16).

The parents of the HIV-positive children say that doctors charged them $20 for 14 ounces of blood and shared the profits with the local blood bank. Some of the doctors in Shymkent say their low wages force them to find ways of earning additional income, and a profit of up to $10 on each blood transfusion is a significant amount because doctors' salaries begin at $175 monthly. Judge Ziyadinkhan Pirniyaz, who presided over the case, gave suspended sentences to senior health official Nursulu Tasmagambetova and three others. The remaining defendants received jail sentences ranging from a few months to eight years. Pirniyaz listed evidence of negligence, abuse of patients and theft of health funds. The attorneys for the children's parents said they will appeal the decision.

"Salaries are very low, and even increases don't make a difference because of inflation," Amangeldy Shopaer -- deputy chief physician at the Shymkent Infectious Diseases Hospital, where all the HIV-positive children have received treatment -- said. The children's families say government neglect has compounded their situation. In addition, many of the children's families have been forced to move after experiencing HIV/AIDS-related discrimination (Kaiser Daily HIV/AIDS Report, 6/28). Kazakh authorities have reacted to the outbreak by building a new children's hospital in Shymkent. In addition, old hospitals will receive new equipment, doctors will be retrained and hospital administrations will undergo weekly inspections, the Tribune reports.

According to the Tribune, nine people in Andijan, Uzbekistan, in March contracted HIV after receiving blood transfusions from an HIV-positive donor who recently had been released from prison. In addition, officials in Osh, Kyrgyzstan, in July fired several doctors for infecting 22 people, including 17 children, with HIV.

Although HIV prevalence is low in Central Asia compared with other former Soviet republics, experts say the region could experience an increase in cases if prevention is not made a priority, the Tribune reports. "Shymkent rang a bell for Central Asia," Nicolas Cantau -- regional director of the AIDS Foundation East-West office in Almaty, Kazakhstan -- said, adding that the region is "in the same place Ukraine was seven years ago, when authorities missed an opportunity to contain the problem and now have seen (nearly) 1% of their population become HIV-positive." There are an estimated 12,000 HIV cases in Kazakhstan, the Tribune reports (Chicago Tribune, 9/16).

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