title: Frequent patient-to-patient transmission of hepatitis C virus in a haematology ward.
abstract: Blood transfusion is a well-documented route of transmission of hepatitis C virus (HCV). However, a persisting high frequency of HCV infections was recorded in our haematology ward even after screening of blood donors had been introduced. We investigated the viral strains in 37 patients with haematological malignant diseases who had developed hepatitis C when treated in the ward during 1990-93. 17 of the patients acquired hepatitis C despite being transfused only with blood components screened by second-generation anti-HCV tests. The viral strains were characterised by PCR genotyping and nucleotide sequencing of the hypervariable region of the E2 gene. Five clusters of closely related or identical viruses were found involving 2, 3, 4, 6, and 15 patients, respectively. Blood components could be ruled out as the common source of infection because no donor had given blood to all patients sharing a specific strain, and even donors whose blood had been given to several patients were negative for HCV RNA. All patients in each cluster had been treated in the ward during overlapping periods. These findings suggest that despite strict hygienic control, HCV transmission occurred between patients treated in the same hospital setting, as has previously been reported in a smaller group of haemodialysis patients.
authors.affiliation: Department of Medicine, Karolinska Institute, Karolinska Hospital, Stockholm, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Allander
authors.forename: A
authors.initials: A
authors.lastname: Gruber
authors.forename: M
authors.initials: M
authors.lastname: Naghavi
authors.forename: A
authors.initials: A
authors.lastname: Beyene
authors.forename: T
authors.initials: T
authors.lastname: Söderström
authors.forename: M
authors.initials: M
authors.lastname: Björkholm
authors.forename: L
authors.initials: L
authors.lastname: Grillner
authors.forename: M A
authors.initials: MA
authors.lastname: Persson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000595:Amino Acid Sequence; D001483:Base Sequence; D016913:Blood Component Transfusion; D003428:Cross Infection / Q000453:epidemiology*; D017931:DNA Primers; D004196:Disease Outbreaks; D018562:Disease Transmission, Infectious; D004781:Environmental Exposure; D005838:Genotype; D006402:Hematologic Diseases / Q000628:therapy; D006405:Hematology; D016174:Hepacivirus / Q000235:genetics*; D006526:Hepatitis C / Q000453:epidemiology* / Q000635:transmission*; D006801:Humans; D008875:Middle Aged; D008969:Molecular Sequence Data; D010362:Patients' Rooms; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis; D013548:Sweden / Q000453:epidemiology
chemical_list: D017931:DNA Primers; D012367:RNA, Viral