Post-transfusion hepatitis type B: long incubation period and poor prognosis in compromised hosts

Seven cases of post-transfusion hepatitis type B [PTH(B)] were investigated. PTH(B) developed in 4 patients more than 65 years old and in 4 patients after treatment of a malignant disease (2 cases of gastric cancer and one each of ovarian cancer and chronic myelogenous leukemia, respectively). The mean incubation period was 78 days (70-90) in patients with non-malignant diseases and 147 days (105-200) in patients with malignant diseases. The symptoms of acute hepatic failure developed in 6 patients and 5 of them expired. One fatal case revealed 4 units of blood and an investigation of 4 donors revealed that one of them was an HBsAg carrier with negative serum HBsAg by the reverse passive hemagglutination (RPHA) method. From these results, it was concluded that compromised hosts such as aged patients or patients with malignant diseases are apt to contract severe PTH(B) with a long incubation period when the transfused blood contains small amounts of HBV.