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Post-transfusion hepatitis
Abstract:
Prospective international studies have shown the incidence of post-transfusion hepatitis in the 1980s to vary between 2% and 31%. Rare cases of hepatitis B continue to occur despite donor screening for the hepatitis B surface antigen, but most are of the non-A, non-B type. Non-A, non-B hepatitis is typically mild and often subclinical in the acute phase but has a tendency to become chronic in about half the affected subjects. The recently characterised hepatitis C virus has been shown to cause most, if not all, transfusion associated non-A, non-B hepatitis. Hepatitis C seropositivity seems to be associated with viraemia and infectivity among blood donors, and donor screening for these antibodies has now been instituted in many countries. New assays now being developed are improving the sensitivity and specificity of this screening, which is estimated to prevent most cases perhaps 70 to 80% of post-transfusion hepatitis.
Insights
Hepatitis C virus causes most post-transfusion hepatitis. Donor screening for hepatitis C antibodies is now common, preventing a significant majority of these infections.
Area of Science:
- Hepatology
- Infectious Diseases
- Transfusion Medicine
Background:
- Post-transfusion hepatitis incidence in the 1980s ranged from 2% to 31%.
- Hepatitis B cases persist despite donor screening, but non-A, non-B hepatitis is more common.
- Non-A, non-B hepatitis often becomes chronic, with hepatitis C virus identified as the primary cause.
Purpose of the Study:
- To summarize the epidemiology and prevention of post-transfusion hepatitis.
- To highlight the role of hepatitis C virus in transfusion-associated hepatitis.
- To discuss the impact of donor screening for hepatitis C.
Main Methods:
- Review of prospective international studies on post-transfusion hepatitis.
- Characterization of hepatitis C virus as the causative agent of non-A, non-B hepatitis.
- Evaluation of donor screening strategies for hepatitis C antibodies.
Main Results:
- Hepatitis C virus is responsible for most transfusion-associated non-A, non-B hepatitis.
- Hepatitis C seropositivity in donors correlates with viremia and infectivity.
- Donor screening for hepatitis C antibodies is implemented globally.
Conclusions:
- Hepatitis C screening significantly reduces post-transfusion hepatitis.
- Improved screening assays enhance sensitivity and specificity.
- Current screening methods are estimated to prevent 70-80% of post-transfusion hepatitis cases.