Results of a hepatitis C general transfusion lookback program for patients who received blood products before July 1992.
BACKGROUND
The Centers for Disease Control and Prevention recommend hepatitis C virus (HCV) antibody (anti-HCV) screening for persons who received blood products before July 1992. A general transfusion lookback program was implemented to identify, counsel, and screen persons who received transfusions at the Alaska Native Medical Center between January 1980 and July 1992.


METHODS
Hard-copy transfusion records data were entered, and available databases were queried to identify deceased patients and the mailing address of those living. Patients were notified by letter of their HCV risk and encouraged to seek counseling and testing. Serum samples were screened for anti-HCV and HCV RNA, and program costs were estimated.


RESULTS
Overall, 3169 transfusion recipients were identified, with 1356 (43%) living and targeted for notification. Of 764 patients notified and screened by this program, 41 (5%) were anti-HCV-positive and 19 (2%) were HCV RNA-positive. There was a higher probability of detecting anti-HCV with each subsequent increase of a transfusion event. Among 298 lookback patients, 33 percent were unaware of having received a blood transfusion. The estimated cost per person sent notification was US$57 and to detect an anti-HCV-positive case it was US$3146.


CONCLUSIONS
This general transfusion lookback program successfully notified and screened patients at a reasonable cost. Further investigation would be helpful in determining the role these programs or other measures could play in promoting HCV screening in persons receiving transfusions before July 1992, especially among those who are unaware of their transfusion history.
Williams
James L
JL
Liver Disease and Hepatitis Program and the Community Health Aide Program, Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, Alaska 99508, USA. jwilliam@anmc.org
Cagle
Henry H
HH
Christensen
Carol J
CJ
Fox-Leyva
Leslie K
LK
McMahon
Brian J
BJ
D000413:Alaska; D001803:Blood Transfusion / Q000191:economics / Q000592:standards; D003365:Costs and Cost Analysis; D018563:Disease Notification; D018562:Disease Transmission, Infectious / Q000706:statistics & numerical data; D005240:Feasibility Studies; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D006526:Hepatitis C / Q000097:blood / Q000635:transmission*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D008403:Mass Screening; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies; D012307:Risk Factors; D012698:Serologic Tests / Q000379:methods; D065227:Transfusion Reaction
D018937:Hepatitis C Antibodies; D012367:RNA, Viral