title: Evidence that use of a second-generation hepatitis C antibody assay prevents additional cases of transfusion-transmitted hepatitis.
abstract: The aim of this study was to determine if using hepatitis C antibody (anti-HCV) enzyme immunoassay version 2.0 (EIA2) in addition to version 1.0 (EIA1) increased the safety of the blood supply. Blood non-reactive by anti-HCV EIA1 was transfused in 1990-92. Stored samples from 40098 units, donated prior to 13 March 1992 were later tested by EIA2. For donor units reactive for anti-HCV by EIA2, a recombinant immunoblot assay (RIBA2) was also carried out. In 63 cases, recipients of transfusions which were EIA2 negative or EIA2 reactive were tested for anti-HCV and elevated alanine aminotransferase (ALT) levels 9-12 months after transfusion; pretransfusion anti-HCV status of recipients was unknown. Among these multitransfused patients receiving units that were negative by both EIA1 and EIA2, 1/26 (4%) had anti-HCV. Among transfusion recipients of units negative by EIA1, but who received at least one unit reactive by EIA2, 4/37 recipients (11%) were anti-HCV reactive (P = 0.59). For the recipients of EIA2 reactive blood, when the donor unit was RIBA2 non-reactive, 0/23 recipients were reactive by anti-HCV. Among the recipients of a RIBA2 indeterminate unit, 1/10 recipients had anti-HCV, but for patients who received at least one RIBA2 reactive unit, 3/4 recipients had anti-HCV (P = 0.03). Hence, second-generation anti-HCV testing detected additional units capable of transmitting hepatitis C that were not detected by first-generation testing. However, RIBA2 is a more specific method than EIA2 for determining units capable of transmitting HCV.
authors.affiliation: Sacramento Medical Foundation Blood Center, CA 95816, USA.
authors.forename: S K
authors.initials: SK
authors.lastname: Aoki
authors.forename: I K
authors.initials: IK
authors.lastname: Kuramoto
authors.forename: S
authors.initials: S
authors.lastname: Anderson
authors.forename: V
authors.initials: V
authors.lastname: Schoening
authors.forename: R
authors.initials: R
authors.lastname: Rodriguez
authors.forename: L
authors.initials: L
authors.lastname: Fernando
authors.forename: K
authors.initials: K
authors.lastname: Sazama
authors.forename: P V
authors.initials: PV
authors.lastname: Holland
mesh_terms: D000368:Aged; D001782:Blood Donors; D005260:Female; D006526:Hepatitis C / Q000517:prevention & control*; D018937:Hepatitis C Antibodies / Q000097:blood*; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D065227:Transfusion Reaction
chemical_list: D018937:Hepatitis C Antibodies