Transfusion-associated hepatitis in a tertiary referral hospital in India

Background and Objectives: In Indian blood banks, screening for hepatitis B virus (HBV) is currently done by the EIA method, but no routine screening is done for hepatitis C virus (HCV). Materials and Methods: To determine th e incidence of transfusion-associated HCV hepatitis, and of any residual tr ansfusion-associated hepatitis (TAH) after HBsAg screening, we prospectivel y studied 182 patients who underwent surgery and received blood transfusion . These recipients had normal alanine aminotransferase (ALT) and were negat ive for HBsAg (monoclonal EIA), and anti-HCV (third-generation EIA) before receiving transfusion. Results: Of the 818 blood units transfused after rou tine screening (average 4.49+/-3.3 U/patient, range 1-14), 14 (1.7% of unit s) were found to be infected. Of the 182 recipients, 14 (7.69%) developed T AH during a follow-up of 6 months, 3 (21.4%) from HBV, 10 (71.5%) from HCV, and 1 (1.7%) from a coinfection of HBV and HCV. All patients with TAH due to HCV were asymptomatic. One patient with TAH due to HBV (33%) and 5 with TAH due to HCV (50%) developed chronic infection with persistently elevated ALT at 6 months. Conclusions: With the current screening practices, the in cidence of TAH remains high in India and is mainly due to HCV infection. Fu rthermore, the screening methods for HBV also need to be improved. Material s and Methods: To determine the incidence of transfusion-associated HCV hep atitis, and of any residual transfusion-associated hepatitis (TAH) after HB sAg screening, we prospectively studied 182 patients who underwent surgery and received blood transfusion. These recipients had normal alanine aminotr ansferase (ALT) and were negative for HBsAg (monoclonal EIA), and anti-HCV (third-generation EIA) before receiving transfusion. Results: Of the 818 bl ood units transfused after routine screening (average 4.49+/-3.3 U/patient, range 1-14), 14(1.7% of units) were found to be infected. Of the 182 recip ients, 14 (7.69%) developed TAH during a follow-up of 6 months, 3 (21.4%) f rom HBV, 10 (71.5%) from HCV, and 1 (1.7%) from a coinfection of HBV and HC V. All patients with TAH due to HCV were asymptomatic. One patient with TAH due to HBV (33%) and 5 with TAH due to HCV (50%) developed chronic infecti on with persistently elevated ALT at 6 months. Conclusions: With the curren t screening practices, the incidence of TAH remains high in India and is ma inly due to HCV infection. Furthermore, the screening methods for HBV also need to be improved.