POSTTRANSFUSION HEPATITIS TYPE-B FOLLOWING MULTIPLE TRANSFUSIONS OF HBSAG-NEGATIVE BLOOD

Background/Aims: Post-transfusion hepatitis continues to occur, though with decreasing frequency, even after screening donor blood for HBsAg , anti-HBc, anti-HCV and alanine aminotransferase activity, Data from developing countries on the frequency and type of post-transfusion hep atitis are scarce, We undertook this prospective study to determine th e incidence and type of post-transfusion hepatitis at our center after transfusion of blood negative for HBsAg by ELISA. Methods: Forty-one patients undergoing open-heart surgery, who had received 3 or more uni ts of HBsAg-negative blood, were followed up, Serum samples of donor u nits transfused to recipients who developed post-transfusion hepatitis -B were subjected to HBV DNA amplification by the polymerase chain rea ction, using two sets of X-gene specific primers which amplified a 250 -bp fragment of the HBV DNA. Results: We found that six of the 41 pati ents (14.6%) developed post-transfusion hepatitis; four of them (66.6% ) developed icteric post-transfusion hepatitis B, whereas two (33.3%) developed anicteric post-transfusion hepatitis C. These six recipients received a total of 48 units of blood and 30 of these 48 units could be subjected to HBV DNA amplification by polymerase chain reaction, El even donor samples were polymerase chain reaction positive and had bee n transfused to three of the four patients who had developed post-tran sfusion hepatitis B. Conclusions: We conclude that post-transfusion he patitis B continues to be the most common cause of post-transfusion he patitis in India, Screening of donor units for HBsAg by ELISA does not exclude all blood units infectious for hepatitis B virus, Additional measures to ensure safety of blood supply should be sought.