Evaluation of antibodies to hepatitis c virus in a study of transfusion-associated hepatitis

Juan I. Esteban, Antonio González, José M. Hernández, Luis Viladomiu, Carmen Sánchez, Juan C. López-Talavera, David Lucea, Carmen Martin-Vega, Xavier Vidal, Rafael Esteban, Jaime Guardia

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318 Citations (Scopus)

Abstract

The hepatitis C virus (HCV) is now known to be the chief cause of transfusion-associated non-A, non-B hepatitis, but the prevalence of HCV among blood donors and the frequency of transmission by blood transfusion are unknown. To assess the sensitivity and specificity of a test for antibody to HCV, we tested serum samples from participants in a large study of transfusion-associated hepatitis. Samples were obtained prospectively from consecutive adults undergoing open-heart surgery in Spain, but were tested retrospectively, after the antibody enzyme immunoassay for anti-HCV became available. Of 280 transfusion recipients given a total of 1109 units of blood, 27 (9.6 percent) had transfusion-associated non-A, non-B hepatitis (mean follow-up, 52 weeks) and 24 of the 27 seroconverted to anti-HCV—positive, whereas only 2 (0.8 percent) of the remaining transfusion recipients seroconverted. Among the 1044 donor specimens available for testing, 16 (1.5 percent) had anti-HCV antibody. Only 1 additional seropositive donor was found when 44 implicated donors who had been seronegative were retested 9 to 12 months later. Of the 16 recipients of anti-HCV—positive blood, 14 (88 percent) had transfusion-associated hepatitis and seroconverted to anti-HCV—positive. The remaining two recipients had neither hepatitis nor anti-HCV antibody. Among 25 patients with non-A, non-B hepatitis for whom all transfused blood was tested, 14 had received blood positive for anti-HCV. About 90 percent of blood donors with antibody to HCV have infectious virus in their blood. The screening of blood donors for anti-HCV antibody should prevent about half the cases of transfusion-associated hepatitis, but the donors with infectious virus who are anti-HCV—negative may remain seronegative for prolonged periods. (N Engl J Med 1990; 323:1107–12.). © 1990, Massachusetts Medical Society. All rights reserved.
Original languageEnglish
Pages (from-to)1107-1112
JournalNew England Journal of Medicine
Volume323
Issue number16
DOIs
Publication statusPublished - 18 Oct 1990

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