Antibodies and viremia in acute post-transfusion hepatitis C: a prospective study

Fourteen patients who developed acute post-transfusion hepatitis C after open-heart surgery were studied for seroconversion, viremia, and aminotransferase. Anti-HCV antibodies were measured by first and second generation ELISA and became positive between one week and more than 6 months after infection. Seroconversion in four patients and passively transfused antibodies were only found by the second generation assay, indicating its significantly higher sensitivity. Viremia was detected by reverse transcription and the polymerase chain reaction within the first 4 weeks of infection in 13 patients and persisted for more than 2 years in all of them. One patient died of cardiac cause. Viral strains were heterogeneous between the different patients, but showed no significant variation within one patient during the course of hepatitis deduced from the results with different sets of oligonucleotides. Viremia preceded hepatitis by 4 weeks, seroconversion determined by ELISA II followed after an 8 week interval, and anti-C-100 antibodies appeared 26 weeks later. Aminotransferase activities returned to normal values in 10 patients.