Hepatitis C Virus Transmission, 1988–1991, via Blood Components from Donors Subsequently Found to be Anti-HCV-positive

Abstract

The recipients of blood components, from the first 12 anti-hepatitis C virus (HCV) positive donors identified by blood donor screening, 1985-1991, were traced retrospectively and tested to assess the HCV transmission rate, HCV genotypes and disease severity. Three enzyme-linked immunosorbent assay (ELISA) positive but RIBA-indeterminate and HCV RNA-negative donors did not transmit HCV to their 9 traced recipients. Nine RIBA- and HCV RNA-positive donors had donated blood to 27 now living recipients of whom 16/27 (59%) were viraemic 1-5 years later. Nine recipients had resolved infection, as determined by PCR HCV RNA. Five of these were RIBA-2 positive but HCV RNA-negative and 4 recipients were RIBA-2-indeterminate and HCV RNA-negative. Two recipients negative in all tests had probably received blood before the donor became infected with HCV. The HCV genotype in each case was identical between the donor and the recipient. Of the viraemic recipients, 50% (8/16) were unsuitable for further investigation or therapy due to their high age and/or underlying severe disease. At most, only 30% (8/27) of the recipients were suitable for further investigation and/or treatment. Two of these were already diagnosed as being infected with HCV before being traced. It is concluded that the benefit of a general tracing of recipients of blood components from HCV-infected donors is doubtful since only a few of them are suitable candidates for treatment. Our results seem to indicate that it is more appropriate to recommend anti-HCV testing to those seeking medical care who have received transfusions or undergone major surgery before 1992, i.e. before anti-HCV-screening was initiated.

Systematic review of role of polymerase chain reaction in defining infectiousness among people infected with hepatitis C virus

“…A total of 29 articles published between 1992 and 1996 fulfilled the above criteria; 21 of these studies examined vertical hepatitis C transmission 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 with the remainder examining hepatitis C transmission after bone marrow or solid organ transplantation (n=3),32 33 34 transfusion of blood components (n=3),35 36 37 and needlestick exposure (n=2) 38 39…”

“…Three retrospective studies of transmission after transfusion of blood components from donors positive for hepatitis C antibodies demonstrated a pooled transmission rate of 83% (74% to 92%) from donors positive by polymerase chain reaction compared with no definite case of transmission among 97 recipients of blood components from negative donors 35 36 37. One study found two recipients of blood component from donors negative by polymerase chain reaction to be positive for hepatitis C antibody (one negative by polymerase chain reaction, one positive), but pre-existing infection with hepatitis C could not be excluded as they had received multiple previous transfusions.…”

“…Even in situations where the hepatitis C inoculum was large, such as after blood transfusion, no definite case of transmission from a person positive for hepatitis C antibody but negative by polymerase chain reaction was documented 35 36 37…”

Hepatitis C Virus Genotypes among Blood Donors and Their Recipients in Iceland Determined by the Polymerase Chain Reaction

“…abuse, practical ly all infected recipients had both viremia and liver injury at the time when they were traced. In a similar retrospective study conducted in Sweden and PCR-analyzed at the same site with the same methods, both recipient viremia and liver damage was somewhat less frequent [13]. The reason for such differences may be related to differences in the recip ient populations or more likely, due to the fact that all do nors were HCV PCR-positive in this Icelandic study.…”

Anti-hepatitis C virus seroprevalence in the working age population in Poland, 2004 to 2014

“…HCV is transmitted mostly by percutaneous exposure to blood [7,8], including intravenous drug injection, which is becoming an important route, especially in developed countries [9,10]. Mother-to-child transmission occurs as well; however, it is relatively uncommon, affecting an estimated 4% of children of HCV-infected mothers [11,12].…”