1. Home>
2. Specialties>
3. General Medicine>
4. Summary and Comment

LIMITATIONS OF HCV ANTIBODY TESTING IN PREVENTING TRANSFUSION-ASSOCIATED HEPATITIS.

The discovery of hepatitis C virus (HCV) as the main cause of non-A, non-B hepatitis (NANBH) fostered the hope that testing of blood donors for antibodies to HCV would virtually eliminate transfusion-associated hepatitis. A prospective study of 280 patients who received transfusions between 1988 and 1989, before HCV testing was available, reveals both the benefits and limitations of current HCV testing.

NANBH developed in 27 of the 280 subjects (9.6 percent); 24 of these 27 acquired antibody to HCV, indicating that this virus was the cause of almost all cases of transfusion- associated hepatitis. Two other patients seroconverted to HCV but did not have hepatitis, indicating that nearly all new transfusion-produced HCV infections led to disease.

Retrospective testing of the frozen donor blood yielded a disturbing finding: HCV antibody was detected in donor blood in only 16 of the 24 patients with NANBH due to HCV, indicating that current testing for HCV antibody does not detect transmissible HCV infection in about one-third of those blood donors who have HCV infection.

Although this study implies that current HCV-antibody tests are beneficial in reducing the risk of transfusion- associated hepatitis, it also suggests that more sensitive tests (for HCV antibody, antigen, or nucleic acid) are needed if transfusion-associated hepatitis -- and the chronic liver disease that often develops from it

— are to be eliminated. --ALK

Published in Journal Watch General Medicine October 19, 1990

Citation(s):

Esteban JI et al. Evaluation of antibodies to hepatitis C virus in a study of transfusion-associated hepatitis. N Engl J Med 1990 Oct 18 323 1107-1112.

• Medline abstract (Free)