For the first time in the United States in over 20 years, organ recipients in Chicago became infected with HIV when an organ donor’s HIV status went undetected (chicagotribune.com, 11/13).

The organ transplants took place in January at three Chicago hospitals. However, the four individuals receiving organs from the at-risk donor did not learn that they had become infected until this month. The recipients also contracted hepatitis C.

The donor had previously been screened for HIV and hepatitis C after a questionnaire revealed that he had engaged in high-risk activity for infection. When tests came back negative, doctors at Rush University Medical Center, University of Chicago Medical Center and Northwestern Memorial Hospital proceeded with the transplants.

“It’s a risk-versus-benefit calculation,” says Alison Smith, vice president for operations at Gift of Hope Organ & Tissue Donation, who conducted the tests approving the organs for donation. “Every patient in need of an organ has a significant medical condition that in most circumstances limits life expectancy. The question becomes what degree of risk is appropriate in that situation.”

Doctors believe that the donor was exposed to HIV in the last three weeks before death. This could result in a negative test for antibodies despite the presence of the virus.