Infectivity of blood seropositive for hepatitis C virus antibodies.
Stored serum samples from 5150 blood product transfusions and 383 recipients were tested for antibodies to hepatitis C virus (anti-HCV) by a recombinant enzyme-linked immunosorbent assay (ELISA) as part of a prospective study on post-transfusion non-A, non-B hepatitis (NANBH). Donor cofactors associated with HCV infectivity of anti-HCV-positive blood products were raised alanine aminotransferase concentrations (6 of 9 infective vs 1 of 26 not infective); a mean ELISA optical density/cut-off ratio greater than or equal to 2 (7 of 9 vs 9 of 26); both preceding factors (together in 6 blood products, all of which transmitted infection); and persistent donor anti-HCV seropositivity. Use of anti-HCV screening to prevent post-transfusion NANBH was compared with measurement of alanine aminotransferase concentrations: a corrected efficacy of 63% and 65%, a specificity of 93% and 64%, and a positive predictive value of 16.2% and 3.6% were found, respectively; 0.7% or 3.8% of blood donations, respectively, would be discarded. Blood donor screening for anti-HCV is recommended to reduce the incidence of post-transfusion NANBH.
van der Poel
C L
CL
Red Cross Blood Bank, Amsterdam, Netherlands.
Reesink
H W
HW
Schaasberg
W
W
Leentvaar-Kuypers
A
A
Bakker
E
E
Exel-Oehlers
P J
PJ
Lelie
P N
PN
D000410:Alanine Transaminase / Q000097:blood*; D001782:Blood Donors; D005069:Evaluation Studies as Topic; D005500:Follow-Up Studies; D006508:Hepatitis Antibodies / Q000032:analysis*; D006526:Hepatitis C / Q000097:blood / Q000209:etiology / Q000276:immunology / Q000517:prevention & control / Q000635:transmission*; D006525:Hepatitis, Viral, Human / Q000635:transmission*; D006801:Humans; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D065227:Transfusion Reaction
D006508:Hepatitis Antibodies; D000410:Alanine Transaminase