HEPATITIS-C SEROPREVALENCE IN BONE-MARROW TRANSPLANT RECIPIENTS AND HEMOPHILIACS

Aim. To determine the prevalence of antibodies to hepatitis C (anti-HC V) in patients who have undergone bone marrow transplantation in Welli ngton, prior to the introduction of hepatitis C screening, and to cont rast these results with the prevalence of anti-HCV in the Wellington h aemophiliac population. Method. Serum specimens were obtained from 30 patients who had undergone bone marrow transplantation for the treatme nt of haematalogical disorders, and from 29 haemophiliacs. Specimens w ere analysed using a second generation HCV immunoassay. Results. Expos ure to blood products was high in bone marrow transplant recipients wi th subjects receiving red cells or platelets from an average of 53 don ors (range 15-100, SD 23.2) during their transplant procedure. Despite the high usage of blood products, only one of the 30 patients tested was positive for hepatitis C on the basis of second-generation antibod y testing. Confirmatory testing in this patient, (anti-HCV immunoblot assay) was negative. In contrast, 26 of 29 (89%) haemophiliac patients tested were positive for anti-HCV. Conclusion. Although the infective risk of blood products cannot be underestimated, the risk of patients contracting hepatitis C from multiple single-unit transfusions, prior to the introduction of screening for hepatitis C was low. This contra sts with the high risk of hepatitis C seroconversion in patients expos ed to pooled plasma products.