Williams James L, Cagle Henry H, Christensen Carol J, Fox-Leyva Leslie K, McMahon Brian J
Liver Disease and Hepatitis Program and the Community Health Aide Program, Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, Alaska 99508, USA.
Transfusion. 2005 Jun;45(6):1020-6. doi: 10.1111/j.1537-2995.2005.04280.x.
The Centers for Disease Control and Prevention recommend hepatitis C virus (HCV) antibody (anti-HCV) screening for persons who received blood products before July 1992. A general transfusion lookback program was implemented to identify, counsel, and screen persons who received transfusions at the Alaska Native Medical Center between January 1980 and July 1992.
Hard-copy transfusion records data were entered, and available databases were queried to identify deceased patients and the mailing address of those living. Patients were notified by letter of their HCV risk and encouraged to seek counseling and testing. Serum samples were screened for anti-HCV and HCV RNA, and program costs were estimated.
Overall, 3169 transfusion recipients were identified, with 1356 (43%) living and targeted for notification. Of 764 patients notified and screened by this program, 41 (5%) were anti-HCV-positive and 19 (2%) were HCV RNA-positive. There was a higher probability of detecting anti-HCV with each subsequent increase of a transfusion event. Among 298 lookback patients, 33 percent were unaware of having received a blood transfusion. The estimated cost per person sent notification was US$57 and to detect an anti-HCV-positive case it was US$3146.
This general transfusion lookback program successfully notified and screened patients at a reasonable cost. Further investigation would be helpful in determining the role these programs or other measures could play in promoting HCV screening in persons receiving transfusions before July 1992, especially among those who are unaware of their transfusion history.
疾病控制与预防中心建议对1992年7月之前接受过血液制品的人员进行丙型肝炎病毒（HCV）抗体（抗-HCV）筛查。实施了一项通用输血追溯计划，以识别、咨询和筛查1980年1月至1992年7月期间在阿拉斯加原住民医疗中心接受输血的人员。
输入硬拷贝输血记录数据，并查询可用数据库以识别已故患者及在世患者的邮寄地址。通过信件通知患者其感染HCV的风险，并鼓励他们寻求咨询和检测。对血清样本进行抗-HCV和HCV RNA筛查，并估算项目成本。
总体而言，共识别出3169名输血接受者，其中1356名（43%）在世并作为通知对象。通过该计划通知并筛查的764名患者中，41名（5%）抗-HCV呈阳性，19名（2%）HCV RNA呈阳性。随着输血次数的增加，检测到抗-HCV的可能性更高。在298名追溯患者中，33%的人不知道自己接受过输血。发送通知的人均估计成本为57美元，检测出一例抗-HCV阳性病例的成本为3146美元。
这项通用输血追溯计划以合理的成本成功通知并筛查了患者。进一步的调查将有助于确定这些计划或其他措施在促进对1992年7月之前接受输血的人员进行HCV筛查方面所起的作用，尤其是那些不知道自己输血史的人员。
