FREQUENT PATIENT-TO-PATIENT TRANSMISSION OF HEPATITIS-C VIRUS IN A HEMATOLOGY WARD

Blood transfusion is a well-documented route of transmission of hepati tis C virus (HCV). However, a persisting high frequency of HCV infecti ons was recorded in our haematology ward even after screening of blood donors had been introduced. We investigated the viral strains in 37 p atients with haematological malignant diseases who had developed hepat itis C when treated in the ward during 1990-93. 17 of the patients acq uired hepatitis C despite being transfused only with blood components screened by second-generation anti-HCV tests. The viral strains were c haracterised by PCR genotyping and nucleotide sequencing of the hyperv ariable region of the E2 gene. Five clusters of closely related or ide ntical viruses were found involving 2, 3, 4, 6, and 15 patients, respe ctively. Blood components could be ruled out as the common source of i nfection because no donor had given blood to all patients sharing a sp ecific strain, and even donors whose blood had been given to several p atients were negative for HCV RNA. All patients in each cluster had be en treated in the ward during overlapping periods.These findings sugge st that despite strict hygienic control, HCV transmission occurred bet ween patients treated in the same hospital setting, as has previously been reported in a smaller group of haemodialysis patients.