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Post-transfusion hepatitis revisited.
Med J Aust 1995; 163(2):74-7MJ

Abstract

OBJECTIVE

To evaluate the risk of post-transfusion and postoperative non-A non-B hepatitis in Australia immediately before the introduction of screening for hepatitis C.

DESIGN

Retrospective testing of blood samples from a prospective study of cardiac surgery patients. Samples were taken from transfusion recipients and non-transfused controls at regular intervals for 12 months after surgery during 1987-1989. For all donor, recipient and control samples, alanine aminotransferase (ALT) levels were measured and tests for antibody to hepatitis B (anti-HBc, anti-HBs) and, when available, to hepatitis C (anti-HCV) were performed.

SETTING

Cardiac surgery units.

PARTICIPANTS

Participants were included if they lived in the metropolitan area, and had not had a transfusion in the past year.

MAIN OUTCOME MEASURES

Post-transfusion hepatitis (two consecutive samples showing raised ALT levels, > 90 IU/L with no other known cause); hepatitis C infection and carriage (antibody to hepatitis C).

RESULTS

Post-transfusion hepatitis occurred in 1.1% of 736 recipients of blood not screened for hepatitis C (i.e., two cases per 1000 unscreened units given). No hepatitis occurred in 514 controls. Seven of the eight patients with post-transfusion hepatitis seroconverted to hepatitis C virus infection. Seven of the 26 anti-HCV-positive donations transmitted hepatitis C, six of these were positive by recombinant immunoblot assay (RIBA) (one by second generation testing only) and one was RIBA indeterminate. Nineteen were RIBA non-reactive; one transmitted hepatitis but the recipient did not develop anti-HCV, although hepatitis C RNA was detected in the donation. Serum ALT was raised in four of the six infective donations.

CONCLUSIONS

Hepatitis C virus infection accounted for almost all cases of non-A non-B post-transfusion hepatitis. First generation anti-HCV tests detected about 85% of infective donations. Surrogate testing of donations by ALT or anti-HBc offers no additional advantage.

Authors+Show Affiliations

Australian Red Cross Society Blood Transfusion Service, Sydney, NSW.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

7542359

Citation

Ismay, S L., et al. "Post-transfusion Hepatitis Revisited." The Medical Journal of Australia, vol. 163, no. 2, 1995, pp. 74-7.
Ismay SL, Thomas S, Fellows A, et al. Post-transfusion hepatitis revisited. Med J Aust. 1995;163(2):74-7.
Ismay, S. L., Thomas, S., Fellows, A., Keller, A., Kenrick, K. G., Archer, G. T., ... Cossart, Y. E. (1995). Post-transfusion hepatitis revisited. The Medical Journal of Australia, 163(2), pp. 74-7.
Ismay SL, et al. Post-transfusion Hepatitis Revisited. Med J Aust. 1995 Jul 17;163(2):74-7. PubMed PMID: 7542359.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Post-transfusion hepatitis revisited. AU - Ismay,S L, AU - Thomas,S, AU - Fellows,A, AU - Keller,A, AU - Kenrick,K G, AU - Archer,G T, AU - Wylie,B R, AU - Cossart,Y E, PY - 1995/7/17/pubmed PY - 1995/7/17/medline PY - 1995/7/17/entrez SP - 74 EP - 7 JF - The Medical journal of Australia JO - Med. J. Aust. VL - 163 IS - 2 N2 - OBJECTIVE: To evaluate the risk of post-transfusion and postoperative non-A non-B hepatitis in Australia immediately before the introduction of screening for hepatitis C. DESIGN: Retrospective testing of blood samples from a prospective study of cardiac surgery patients. Samples were taken from transfusion recipients and non-transfused controls at regular intervals for 12 months after surgery during 1987-1989. For all donor, recipient and control samples, alanine aminotransferase (ALT) levels were measured and tests for antibody to hepatitis B (anti-HBc, anti-HBs) and, when available, to hepatitis C (anti-HCV) were performed. SETTING: Cardiac surgery units. PARTICIPANTS: Participants were included if they lived in the metropolitan area, and had not had a transfusion in the past year. MAIN OUTCOME MEASURES: Post-transfusion hepatitis (two consecutive samples showing raised ALT levels, > 90 IU/L with no other known cause); hepatitis C infection and carriage (antibody to hepatitis C). RESULTS: Post-transfusion hepatitis occurred in 1.1% of 736 recipients of blood not screened for hepatitis C (i.e., two cases per 1000 unscreened units given). No hepatitis occurred in 514 controls. Seven of the eight patients with post-transfusion hepatitis seroconverted to hepatitis C virus infection. Seven of the 26 anti-HCV-positive donations transmitted hepatitis C, six of these were positive by recombinant immunoblot assay (RIBA) (one by second generation testing only) and one was RIBA indeterminate. Nineteen were RIBA non-reactive; one transmitted hepatitis but the recipient did not develop anti-HCV, although hepatitis C RNA was detected in the donation. Serum ALT was raised in four of the six infective donations. CONCLUSIONS: Hepatitis C virus infection accounted for almost all cases of non-A non-B post-transfusion hepatitis. First generation anti-HCV tests detected about 85% of infective donations. Surrogate testing of donations by ALT or anti-HBc offers no additional advantage. SN - 0025-729X UR - https://www.unboundmedicine.com/medline/citation/7542359/Post_transfusion_hepatitis_revisited_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0025-729X&date=1995&volume=163&issue=2&spage=74 DB - PRIME DP - Unbound Medicine ER -