[Post-transfusion non-A, non-B hepatitis: is a specific test in sight?]

Area of Science:

• Virology: Identification and characterization of the hepatitis C virus (HCV), a small, single-stranded RNA virus.
• Immunology: Development of enzyme immunoassays (EIA) for detecting HCV-specific antibodies.

Context:

• Non-A, non-B hepatitis (NANB-PTH) poses a significant risk in transfusion medicine, with high attack rates in Germany and the USA.
• The efficacy of traditional surrogate markers like anti-HBc and ALT for NANB-PTH prevention is debated.
• Previous methods for NANB-PTH detection were insufficient, necessitating improved screening.

Purpose:

• To introduce a novel enzyme immunoassay (EIA) for detecting antibodies against the newly identified hepatitis C virus (HCV).
• To assess the preliminary seroprevalence of HCV antibodies in US blood donors and patient populations.
• To evaluate the potential of HCV antibody testing to mitigate transfusion-transmitted NANB-PTH.

Summary:

• A new EIA utilizing an HCV fusion protein detected specific antibodies in patients with NANB-PTH.
• Preliminary US data showed a 0.7% HCV antibody prevalence in blood donors, rising to 45% in NANB patients.
• Critical donor/recipient pair investigations indicated a 73% correlation of seropositivity, supporting test efficacy.

Impact:

• The introduction of HCV antibody testing is expected to substantially decrease the infectious risks associated with homologous blood transfusions.
• A German multicentre pilot study is planned to evaluate an improved HCV antibody EIA.
• Ongoing efforts are focused on developing an HCV vaccine to further combat the virus.