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Post‐transfusion hepatitis revisited
Author(s) -
Ismay Susan L,
Thomas Sally,
Fellows Annette,
Keller Anthony,
Kenrick Kenneth G,
Archer Gordon T,
Wylie Brenton R,
Cossart Yvonne E
Publication year - 1995
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1995.tb126118.x
Subject(s) - medicine , hepatitis , hepatitis c , hepatitis c virus , blood transfusion , hepatitis b , hepatology , antibody , gastroenterology , viral hepatitis , immunology , virology , virus
Objective To evaluate the risk of post‐transfusion and postoperative non‐A non‐B hepatitis in Australia immediately before the introduction of screening for hepatitis C. Design Retrospective testing of blood samples from a prospective study of cardiac surgery patients. Samples were taken from transfusion recipients and non‐transfused controls at regular intervals for 12 months after surgery during 1987‐1989. For all donor, recipient and control samples, alanine aminotransferase (ALT) levels were measured and tests for antibody to hepatitis B (anti‐HBc, anti‐HBs) and, when available, to hepatitis C (anti‐HCV) were performed. Setting Cardiac surgery units. Participants Participants were included if they lived in the metropolitan area, and had not had a transfusion in the past year. Main outcome measures Post‐transfusion hepatitis (two consecutive samples showing raised ALT levels, > 90IU/L with no other known cause); hepatitis C infection and carriage (antibody to hepatitis C). Results Post‐transfusion hepatitis occurred in 1.1% of 736 recipients of blood not screened for hepatitis C (i.e., two cases per 1000 unscreened units given). No hepatitis occurred in 514 controls. Seven of the eight patients with post‐transfusion hepatitis seroconverted to hepatitis C virus infection. Seven of the 26 anti‐HCV‐positive donations transmitted hepatitis C, six of these were positive by recombinant immunoblot assay (RIBA) (one by second generation testing only) and one was RIBA indeterminate. Nineteen were RIBA non‐reactive; one transmitted hepatitis but the recipient did not develop anti‐HCV, although hepatitis C RNA was detected in the donation. Serum ALT was raised in four of the six infective donations. Conclusions Hepatitis C virus infection accounted for almost all cases of non‐A non‐B post‐transfusion hepatitis. First generation anti‐HCV tests detected about 85% of infective donations. Surrogate testing of donations by ALT or anti‐HBc offers no additional advantage.