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[Significance of HCV infection for post-transfusion hepatitis]
1Institut für Virologie, Universitätsklinikum Essen.
Insights
Hepatitis C virus (HCV) infection diagnosis has advanced, but current tests can't distinguish between acute, past, or chronic stages. Confirmatory testing is crucial for blood donors to ensure transfusion safety.
Area of Science:
- Hepatology and Virology
- Infectious Diseases
- Immunology
Context:
- Hepatitis C virus (HCV) characterized five years ago, leading to diagnostic tool development.
- Multiple HCV genotypes (at least six) identified, with potential for reinfection by different genotypes.
- Current serological tests lack the ability to differentiate acute, past, or chronic hepatitis C infections.
Purpose:
- To highlight the limitations of current serological tests for hepatitis C.
- To emphasize the necessity of confirmatory assays and PCR for accurate diagnosis.
- To assess the residual risk of post-transfusion hepatitis C.
Summary:
- Hepatitis C virus (HCV) infection diagnosis has advanced, but current serological tests cannot differentiate between acute, past, or chronic stages.
- Confirmatory testing, including PCR for viral RNA, is essential for blood donors with reactive ELISA results to confirm HCV persistence.
- Systematic screening of blood units has significantly reduced post-transfusion hepatitis C, though a small residual risk remains.
Impact:
- Reduced post-transfusion hepatitis C by up to 95% through systematic blood screening.
- Identified a residual risk of acquiring post-transfusion hepatitis C, estimated between 1:20,000 and 1:50,000.
- Underscores the ongoing importance of robust diagnostic strategies for HCV.
Abstract:
Five years ago the hepatitis C virus has been first characterized, and diagnostic tools have been developed to demonstrate acute or chronic infection. At least six different genotypes have been identified. After a primary HCV infection reinfection with other genotypes seems to be possible. The serological tests currently available cannot differentiate between acute, past or chronic hepatitis C. Blood donors which show a reactive result by ELISA should be retested by a confirmatory assay and PCR for the demonstration of viral RNA to exclude or demonstrate persistence of HCV. Systematic screening of blood units for antibodies to HCV reduced the posttransfusion hepatitis up to 95%. However, there is still a risk for acquiring posttransfusion hepatitis C which is actually calculated to be 1:20,000 up to 1:50,000.