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TRANSFUSION COMPLICATIONS: Declining hepatitis C virus (HCV) prevalence in pregnant women: impact of anti‐HCV screening of donated blood
Author(s) -
Ohto Hitoshi,
Ishii Tsutomu,
Kitazawa Junichi,
Sugiyama Seiji,
Ujiie Niro,
Fujimori Keiya,
Ariga Hiromichi,
Satoh Tomoko,
Nollet Kenneth E.,
Okamoto Hiroaki,
Hoshi Tanji
Publication year - 2010
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2009.02487.x
Subject(s) - medicine , hepatitis c virus , cohort , blood transfusion , hepatitis c , population , risk factor , cohort study , offspring , obstetrics , immunology , pregnancy , virus , environmental health , biology , genetics
BACKGROUND: Screening blood donors for hepatitis C virus (HCV) antibody has effectively mitigated transfusion transmission of HCV. We conducted a post hoc analysis to clarify the impact of donor screening on a general population of reproductive‐age females and their offspring. STUDY DESIGN AND METHODS: Anti‐HCV screening in Japan started in late‐1989. In a cohort studied between May 1990 and November 2004, a total of 22,664 consecutive serum samples from pregnant women were screened for anti‐HCV. Reactive samples were further tested for HCV RNA. Linear structural regression was applied to identify causal relationships. RESULTS: Anti‐HCV–reactive rates declined significantly by two measures. First, among women known to have been transfused, rates fell from 14.8% to 3.1% with the implementation of anti‐HCV screening (p < 0.01). Nevertheless, this is 10 times higher than the 0.3% reactive rate seen in a similar cohort of nontransfused women. Second, rates fell from 1.8% among women born in 1955 or before to 0.3% for women born in 1966 or later (p < 0.01). Among 103 anti‐HCV–reactive women, 31 (30%) had been transfused and another 17 (17%) had other identifiable risk factors. The remaining 55 (53%) had no clear risk factor. Blood transfusion accounted for 19% of anti‐HCV acquisition, by path analysis. Only one infant in this cohort was vertically infected with HCV. CONCLUSION: Anti‐HCV screening of donated blood and hygienic improvements have markedly decreased HCV infection of pregnant women with a transfusion history; however, 70% of anti‐HCV–reactive women were deemed to be infected via routes other than transfusion.