Hepatitis C virus and blood transfusion: past and present risks

Area of Science:

• Transfusion Medicine
• Virology
• Public Health

Background:

• Hepatitis C virus (HCV) transmission via blood products posed a significant risk before the 1980s.
• Key advancements include non-remunerated donor selection, HIV screening, and anti-HCV testing, drastically reducing transmission risks.
• Alanine aminotransferase (ALT) surrogate testing is now obsolete due to the efficacy of direct anti-HCV antibody testing.

Purpose of the Study:

• To evaluate the current residual risk of HCV transmission in blood products.
• To assess the impact of emerging technologies like nucleic acid amplification technology (NAT) on blood safety.
• To project future trends in HCV screening and blood product safety.

Main Methods:

• Review of historical data on HCV transmission and screening methods.
• Analysis of current residual risk estimates for HCV transmission.
• Discussion of the anticipated role of HCV NAT in blood donor screening and plasma product manufacturing.

Main Results:

• The residual risk of HCV transmission from cellular products is approximately 1 in 100,000 transfusions.
• No HCV transmission has been reported from plasma products treated with solvent-detergent inactivation.
• HCV NAT implementation in Europe is anticipated for pooled plasma products and potentially individual donations within two years.

Conclusions:

• Current blood transfusion safety measures have substantially reduced HCV transmission risks.
• HCV NAT implementation is expected to virtually eliminate residual transmission risks.
• The cost-effectiveness of HCV NAT is favorable compared to other public health interventions, with hemovigilance programs providing further safety data.