Impact of screening blood donors for hepatitis C antibody on posttransfusion hepatitis: a prospective study with a second‐generation anti‐hepatitis C virus assay

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Abstract
BACKGROUND: Hepatitis C is the major cause of posttransfusion hepatitis. Blood components that are positive for antibody to hepatitis C virus (anti‐HCV) can transmit posttransfusion hepatitis. STUDY DESIGN AND METHODS: To investigate the effect on posttransfusion hepatitis of screening blood donors with a second‐generation test for anti‐HCV, 249 transfusion recipients who underwent cardiovascular surgery were prospectively followed. Six recipients who were positive for anti‐HCV before transfusion and 51 subjects with incomplete follow‐up were excluded from this study. RESULTS: Eleven (13.8%) of 80 subjects who received unscreened blood had two successive serum alanine aminotransferase levels > 90 U per L. Seven (8.8% of total) developed anti‐HCV and HCV RNA and two (2.5% of total) developed IgM antibody to cytomegalovirus (IgM anti‐CMV). By contrast, 3 (2.7%) of the 112 subjects who received anti‐HCV‐screened blood had two successive serum alanine aminotransferase levels > 90 U per L. None of these three developed anti‐HCV and HCV RNA, but two (1.8% of total) showed the development of IgM anti‐CMV. The study shows that screening for anti‐ HCV in blood donors with a second‐generation test almost abrogated posttransfusion viral hepatitis C. CONCLUSION: After anti‐HCV screening, other body fluid‐transmitted viruses such as CMV may become important in posttransfusion hepatitis.