A case of transfusion-acquired hepatitis C

Area of Science:

• Virology
• Immunology
• Public Health

Background:

• The Blood Transfusion Service implemented Hepatitis C antibody (HCV) screening in September 1991 using second-generation enzyme-linked immunosorbent assays (ELISA).
• Post-transfusion hepatitis C is a significant concern, particularly in vulnerable patient populations like those with myeloma.
• Early detection and prevention of viral transmission through blood donation are critical public health priorities.

Observation:

• A case of post-transfusion hepatitis C was identified in a myeloma patient, with infection acquired prior to the introduction of routine screening.
• Both the patient and the identified blood donor were diagnosed using ELISA and polymerase chain reaction (PCR) assays.
• The diagnosis of the infected donor prevented further transmission of the virus through subsequent blood donations.

Findings:

• Discrepancies were observed in HCV assay results, with samples yielding both positive and negative outcomes depending on the testing method and timing.
• ELISA and PCR assays were instrumental in identifying the infected donor and patient.
• Variability in test results based on sample timing underscores the complexities of HCV diagnosis.

Implications:

• This case underscores the critical importance of confirming positive Hepatitis C virus (HCV) test results using multiple diagnostic methods.
• No single laboratory test is currently entirely satisfactory for definitively diagnosing HCV infection.
• Robust diagnostic strategies are essential for preventing transfusion-transmitted infections and ensuring blood safety.