Prevalence and risk factors of hepatitis C infection after cardiac surgery in childhood before and after blood donor screening.
BACKGROUND
Since 1974, the risk of acquiring non-A non-B hepatitis by blood transfusion is well known. In 1999, children having had polytransfusions (group 1) after cardiac surgery prior to the establishment of routine blood donor screening could be identified as a risk group for hepatitis C (HCV) infection.


METHODS
In 1991, Germany began screening blood donors for hepatitis C. To describe the risk after the implementation of blood donor screening, we studied 211 children (group 2) having had open heart surgery after 1991 and compared prevalence for anti-HCV antibodies and known risk factors to group 1.


RESULTS
None of the 211 patients with cardiac surgery after 1991 had detectable anti-HCV antibodies, compared to 67 of the 458 patients (14.6%) of group 1 (p < 0.001). The mean number of operations in both groups was virtually the same (mean 1.7 +/- 0.9 in group 1, mean 1.6 +/- 0.9 in group 2, p = 0.075), whereas the total number of blood products per patient differed significantly (group 1 mean 8 +/- 17.6, group 2 mean 3.5 +/- 2.8; p < 0.001). Multivariate analysis of risk factors demonstrates affiliation to group 1, transfusion of fresh blood, warm whole blood, heparinized blood (p < 0.001) and plasma (p = 0.004) as significant.


CONCLUSIONS
After the implementation of blood donor screening, the risk for HCV infection after cardiac surgery in childhood dropped significantly from 14.6% to < 0.5%. These data show the necessity of HCV screening for patients at risk (operations before 1991) and do not favor a general screening for all patients.
Vogt
M
M
German Heart Center, Dept. of Pediatric Cardiology and Congenital Heart Disease, Lazarettstr. 36, D-80636 Munich, Germany. drvogt@dhm.mhn.de
Mühlbauer
F
F
Braun
S L
SL
Lang
T
T
Busch
R
R
Lange
R
R
Frösner
G
G
Hess
J
J
D000293:Adolescent; D001782:Blood Donors; D002648:Child; D002675:Child, Preschool; D005260:Female; D016174:Hepacivirus / Q000276:immunology; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008403:Mass Screening; D015995:Prevalence; D012307:Risk Factors; D013903:Thoracic Surgery; D065227:Transfusion Reaction
D018937:Hepatitis C Antibodies