Risk of hepatitis C in patients who received blood from donors subsequently shown to be carriers of hepatitis C virus

Abstract

A retrospective study was undertaken to identify recipients of blood from donors subsequently shown to be positive for hepatitis C virus using second-generation tests and polymerase chain reaction. The main aims were to determine the numbers of such recipients who were still alive and traceable, and to determine the risk of infection in this group. The feasibility and workload of this procedure, which is currently not practised in the U.K. or U.S.A., was also assessed. In the first six months of routine testing 42,697 donors were tested. Of 20 confirmed to be HCV-positive, 15 were regular donors. Eighty-three components were prepared from 63 anti-HCV positive previous donations from these donors. In all, nine recipients were found to be alive. All were positive for anti-HCV. We conclude that although this retrospective procedure is time-consuming and difficult, substantial numbers of infected recipients can be identified. The availability of treatment for chronic hepatitis C for such patients should encourage transfusion services to reassess current policies on the hepatitis C retrospective.

Transfusion‐acquired hepatitis C: the Danish lookback experience

“…The majority of the published lookback experience consists of pilot studies in which tracing efficacy and follow‐up are supposed to be higher than in the routine setting. It is therefore satisfying that the 94‐percent efficacy of the Danish national lookback is comparable to that of the pilot studies (79–94%) 7–9 . Only 7 of 14 counties (responsible for 803 of the 1018 identified recipients) reported tracing efficacy.…”

“…Previous pilot lookback testing of transfusion recipients in Europe has shown that 57 to 100 percent were infected with HCV but several studies have indicated that the yield in terms of recipients who would possibly benefit from the lookback initiative is very low 5–14 . Thus, the national lookback in Denmark was initiated as a political decision rather than as the result of a cost‐benefit analysis.…”

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

“…However, in a recent Scottish report by Ayob et al (9), a reassessment of current policies on HCV tracing was suggested. family members and medical staff.…”

Look-Back of Anti-HCV ELISAPositive, HCV-RNA PCR-Negative Donors and Recipients of Their Blood Products

“…The 54 group B donors donated 548 times (mean 10 per donor, range [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] In our study, we established that blood donations that were anti-HCV ELISA-positive, but cDNA-PCR-negative and negative or indeterminate in RIBA-2 were not infec tious. This is in accordance with the finding that prospec tively followed recipients of anti-HCV ELISA-positive, but cDNA-PCR-negative blood products were not infected with HCV [14][15][16][17].…”

“…How ever, none of 141 recipients of blood components from ELISA-positive/PCR-negative donors, who donated in the period 1986-1992, were ELISA-3-positive. On the other hand, about 80% of recipients of blood products from HCV-RNA-positive donors were HCV-infected [10,20,22]. From our study, we conclude that it is very unlikely that ELISApositive/PCR-negative (RIBA-2-negative or indeterminate) donors are infected with HCV The important implication of our look-back study is that now in The Netherlands it is authorized [23] that ELISApositive donors who are negative by confirmatory cDNA-PCR and/or Immunoblot, can be re-entered in the ranks of blood donors, provided that future donations are ELISAnegative.…”