Detection of antibody to hepatitis C virus in prospectively followed transfusion recipients with acute and chronic non-A, non-B hepatitis.

TitleDetection of antibody to hepatitis C virus in prospectively followed transfusion recipients with acute and chronic non-A, non-B hepatitis.
Publication TypeJournal Article
Year of Publication1989
AuthorsAlter HJ, Purcell RH, Shih JW, Melpolder JC, Houghton M, Choo QL, Kuo G
JournalThe New England journal of medicine//N Engl J Med
Volume321
Issue22
Pagination1494 - 500
Date Published1989
ISBN Number0028-4793
Other Numbers0255562, now
Keywords*Blood Transfusion/ae [Adverse Effects], *Hepatitis Antibodies/an [Analysis], *Hepatitis C/im [Immunology], *Hepatitis, Viral, Human/im [Immunology], Acute Disease, Adult, Aged, Alanine Transaminase/bl [Blood], Blood Donors, Chronic Disease, Female, Hepatitis B Core Antigens/im [Immunology], Hepatitis C/di [Diagnosis], Hepatitis C/tm [Transmission], Humans, Male, Middle Aged, Prospective Studies, Time Factors
Abstract

We measured antibody (anti-HCV) to hepatitis C virus, which causes non-A, non-B hepatitis, by radioimmunoassay in prospectively followed transfusion recipients and their donors. Of 15 patients with chronic non-A, non-B hepatitis documented by liver biopsy, all seroconverted for the antibody; of 5 with acute resolving non-A, non-B hepatitis, 3 (60 percent) seroconverted. The development of anti-HCV was delayed (mean delay, 21.9 weeks after transfusion, or 15 weeks after the onset of clinical hepatitis) and took approximately one year in one patient. Antibody has persisted in 14 of the 15 patients with chronic disease (mean follow-up, greater than or equal to 6.9 years; maximum, greater than or equal to 12), but has disappeared in the 3 with acute resolving disease after a mean of 4.1 years. Anti-HCV was detected in samples of donor serum given to 14 (88 percent) of the 16 anti-HCV-positive patients for whom all donor samples were available. Only 33 percent of the anti-HCV-positive donors tested had an elevated serum concentration of alanine aminotransferase; 54 percent were positive for antibody to the hepatitis B core antigen (anti-HBc). We conclude that hepatitis C virus is the predominant agent of transfusion-associated non-A, non-B hepatitis and that screening of donors for anti-HCV could prevent the majority of cases of the disease. "Surrogate" assays for anti-HBc and alanine aminotransferase would have detected approximately half the anti-HCV-positive donors involved in the transmission of hepatitis that we identified.

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