Frequency and characteristics of post-transfusion hepatitis in Greece with emphasis on hepatitis C: comparing second- and third-generation assays.
In order to evaluate the role of hepatitis C virus (HCV) in post-transfusion hepatitis (PTH) in Greece we prospectively followed 143 transfusion recipients, receiving 790 units of blood and/or products from 789 donors, between October 1989 and December 1991. The mean number of units transfused per patient was 5.52. PTH was observed in 18 patients (12.59%). One patient (0.70%) developed hepatitis B, in four (2.80%) hepatitis could be attributed to CMV infection, 10 (6.99%) developed hepatitis C and three (2.10%) showed only raised alanine aminotransferase (ALT) levels. The risk of PTH per 1000 units transfused was 22.8. The patient who developed hepatitis B (PTH-B) was transfused with four units, one of which was positive for anti-HBc and anti-HBe. Seven of the 10 patients (70%) who developed hepatitis C (PTH-C) were transfused with at least one unit seropositive in the anti-HCV screening with 2nd-generation tests (ELISA-2 and RIBA-2), whereas 9/10 of PTH-C cases (90%) were transfused with at least one unit positive in 3rd-generation assays. Of the three patients who showed only ALT elevation, none was transfused with anti-HCV seropositive blood, although one of them was transfused with at least one unit with elevated ALT levels. We conclude that: (1) the incidence of PTH in Greece remains high, (2) screening of all donations for anti-HCV with an ELISA-2 does not exclude transmission of HCV and (3) ELISA-3 and RIBA-3 seem to be more sensitive in blood donor screening and in detecting seroconversions than ELISA-2 and RIBA-2.
Makris
K
K
Blood Bank, KAT-Hospital, Athens, Greece.
Kouvelis
V
V
Drakopoulos
I
I
Oikonomou
E
E
Maniatis
A
A
D000410:Alanine Transaminase / Q000097:blood; D001782:Blood Donors; D001803:Blood Transfusion; D004797:Enzyme-Linked Immunosorbent Assay; D006115:Greece; D006526:Hepatitis C / Q000453:epidemiology* / Q000635:transmission*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D015151:Immunoblotting; D011446:Prospective Studies; D012307:Risk Factors
D018937:Hepatitis C Antibodies; D000410:Alanine Transaminase