HEPATITIS-C VIRUS TRANSMISSION, 1988-1991, VIA BLOOD COMPONENTS FROM DONORS SUBSEQUENTLY FOUND TO BE ANTI-HCV-POSITIVE

The recipients of blood components, from the first 12 anti-hepatitis C virus (HCV) positive donors identified by blood donor screening, 1988 -1991, were traced retrospectively and tested to assess the HCV transm ission rate, HCV genotypes and disease severity, Three enzyme-linked i mmunosorbent assay (ELISA) positive but RIBA-indeterminate and HCV RNA -negative donors did not transmit HCV to their 9 traced recipients. Ni ne RIBA- and HCV RNA-positive donors had donated blood to 27 now livin g recipients of whom 16/27 (59%) were viraemic 1-5 years later, Nine r ecipents had resolved infection, as determined by PCR HCV RNA. Five of these were RIBA-2 positive but HCV RNA-negative and 4 recipients sere RIBA-2-indeterminate and HCV RNA-negative, Two recipients negative in all tests had probably received blood before the donor became infecte d with HCV. The HCV genotype in each case was identical between the do nor and the recipient, Of the viraemic recipients, 50% (8/16) were uns uitable for further investigation or therapy due to their high age and /or underlying severe disease. At most, only 30% (8/27) of the recipie nts were suitable for further investigation and/or treatment, Two of t hese were already diagnosed as being infected with HCV before being tr aced, It is concluded that the benefit of a general tracing of recipie nts of blood components from HCV-infected donors is doubtful since onl y a few of them are suitable candidates for treatment. Our results see m to indicate that it is more appropriate to recommend anti-HCV testin g to those seeking medical care who have received transfusions or unde rgone major surgery before 1992, i.e. before anti-HCV-screening was in itiated.