The clinical problem of hepatitis transmission;

Area of Science:

• Transfusion Medicine
• Hepatology
• Infectious Diseases

Background:

• Post-transfusion hepatitis (PTH) persists as a major risk despite sensitive hepatitis B surface antigen (HBSAg) testing in blood banks since 1975.
• Prospective studies confirm HBSAg as a marker for hepatitis B virus (HBV), showing reduced transfusion-associated hepatitis B after HBSAg-positive blood exclusion.
• Non-A, non-B hepatitis remains prevalent, often subclinical, but can lead to chronic liver issues.

Purpose of the Study:

• To evaluate the ongoing risks of post-transfusion hepatitis (PTH) despite current screening methods.
• To identify key risk factors contributing to PTH, particularly non-A, non-B hepatitis.
• To discuss strategies for reducing PTH incidence in transfusion recipients.

Main Methods:

• Analysis of prospective studies on post-transfusion hepatitis (PTH) incidence and follow-up of transfused patients.
• Evaluation of hepatitis B surface antigen (HBSAg) as a marker for hepatitis B virus (HBV) and its impact on PTH rates.
• Comparison of hepatitis risk associated with blood from paid versus voluntary donors.

Main Results:

• Eliminating HBSAg-positive blood significantly reduced post-transfusion hepatitis B.
• Blood from paid donors is a major risk factor for PTH, with higher HBSAg and anti-HBS prevalence.
• Non-A, non-B hepatitis continues to be a common cause of PTH, with potential for chronic liver disease.

Conclusions:

• Despite HBSAg testing, post-transfusion hepatitis remains a concern, especially non-A, non-B hepatitis.
• Reducing reliance on blood from paid donors is crucial for mitigating PTH risk.
• Further research into non-A, non-B hepatitis agents and improved donor screening are essential for transfusion safety.