HEPATITIS-C IN BLOOD-TRANSFUSION RECIPIENTS IDENTIFIED AT THE OXFORD-BLOOD-CENTER IN THE NATIONAL HCV LOOK-BACK PROGRAM

After the introduction in September 1991 of donor screening for hepati tis C, 95 potentially infectious blood donors who had given blood befo re this date were identified at the Oxford blood centre. Three hundred and ninety-nine blood components issued previously from these donors were identified in the course of the national HCV look-back programme. Of 399 questionnaires sent to hospital blood banks 392 were returned, identifying 290 recipients of whom 177 (61%) had died, and 113 (39%) were still alive 4-13 years after transfusion. One hundred and four re cipients were traced and tested. Forty-nine recipients were not HCV in fected. Forty-four of 58 (76%) recipients who received blood from dono rs found to be HCV RNA positive after September 1991 gave positive tes t results for HCV RNA. Eleven of 58 showed only antibody (anti-HCV), a nd 3/58 who had apparently received infectious blood showed no sign of past infection. The 11 who showed anti-HCV only, together with the th ree who showed no sign of past infection despite strong evidence of re ceiving HCV RNA-positive blood, had a mean age at transfusion of 27 ye ars, compared with mean age at transfusion of 46 years in the 44 recip ients with persistent HCV infection. Virus genotyping in 33/44 HCV RNA -positive recipients revealed five different genotypes. These did not seem to influence the outcome. Virus genotypes in 31 donor-recipient p airs showed complete concordance. Liver biopsies in 23/44 RNA-positive recipients showed minimal inflammation in four, mild in eight and mod erate in 11. Liver fibrosis, Ishak grades 1-3, was present in 16/23 re cipients. One other male recipient, not subjected to a liver biopsy, d eveloped a hepatocellular carcinoma which caused his death at the age of 71, 8 years after transfusion.