A STUDY OF PRIMARY-INFECTION AND REINFECTION WITH HEPATITIS-C VIRUS IN BLOOD-TRANSFUSION RECIPIENTS

A nested polymerase chain reaction was used to assess viraemia in bloo d transfusion recipients with no serological evidence of hepatitis C v irus (HCV) infection (naive recipients) and in recipients with prior o r existing HCV infection (infected recipients), who were transfused wi th HCV-positive blood. In 10 hepatitis cases in naive recipients, defi ned as primary infection, nine showed clinical hepatitis, and one was sub-clinical; the time between transfusion and elevation of alanine am inotransferase (ALT) levels was 15-60 days (37.9+/-13.9). All 10 naive recipients showed abnormal ALT, and 10/10 and 7/10 were persistently positive for anti-HCV and HCV-RNA, respectively, for more than 1 year. Similarly, in five cases in previously infected recipients, defined a s re-infection, 4/5 showed clinical hepatitis, the time to elevation o f ALT was 30-46 days (34.8+/-6.4), and 5/5 and 3/5 were persistently p ositive for anti-HCV and HCV-RNA, respectively, for more than 1 year. All five infected recipients showed abnormal ALT. In conclusion, there was no significant difference (P = 0.05) in the frequency of the mark ers of infection resulting from primary or re-infection with HCV, sugg esting that primary infection fails to induce a protective immune resp onse.