Esteban J I, González A, Hernández J M, Viladomiu L, Sánchez C, López-Talavera J C, Lucea D, Martin-Vega C, Vidal X, Esteban R
Department of Internal Medicine, Hospital General Universitari Vall d'Hebron, Barcelona, Spain.
N Engl J Med. 1990 Oct 18;323(16):1107-12. doi: 10.1056/NEJM199010183231605.
The hepatitis C virus (HCV) is now known to be the chief cause of transfusion-associated non-A, non-B hepatitis, but the prevalence of HCV among blood donors and the frequency of transmission by blood transfusion are unknown.
To assess the sensitivity and specificity of a test for antibody to HCV, we tested serum samples from participants in a large study of transfusion-associated hepatitis. Samples were obtained prospectively from consecutive adults undergoing open-heart surgery in Spain, but were tested retrospectively, after the antibody enzyme immunoassay for anti-HCV became available.
Of 280 transfusion recipients given a total of 1109 units of blood, 27 (9.6 percent) had transfusion-associated non-A, non-B hepatitis (mean follow-up, 52 weeks) and 24 of the 27 seroconverted to anti-HCV-positive, whereas only 2 (0.8 percent) of the remaining transfusion recipients seroconverted. Among the 1044 donor specimens available for testing, 16 (1.5 percent) had anti-HCV antibody. Only 1 additional seropositive donor was found when 44 implicated donors who had been seronegative were retested 9 to 12 months later. Of the 16 recipients of anti-HCV-positive blood, 14 (88 percent) had transfusion-associated hepatitis and seroconverted to anti-HCV-positive. The remaining two recipients had neither hepatitis nor anti-HCV antibody. Among 25 patients with non-A, non-B hepatitis for whom all transfused blood was tested, 14 had received blood positive for anti-HCV.
About 90 percent of blood donors with antibody to HCV have infectious virus in their blood. The screening of blood donors for anti-HCV antibody should prevent about half the cases of transfusion-associated hepatitis, but the donors with infectious virus who are anti-HCV-negative may remain seronegative for prolonged periods.
目前已知丙型肝炎病毒（HCV）是输血相关的非甲非乙型肝炎的主要病因，但献血者中HCV的流行率以及输血传播的频率尚不清楚。
为评估HCV抗体检测的敏感性和特异性，我们检测了一项大型输血相关肝炎研究中参与者的血清样本。样本前瞻性地取自西班牙连续接受心脏直视手术的成年人，但在抗HCV抗体酶免疫测定可用后进行回顾性检测。
在接受了总共1109单位血液的280名输血受者中，27名（9.6%）发生了输血相关的非甲非乙型肝炎（平均随访52周），其中24名（27名中的）抗HCV血清转化为阳性，而其余输血受者中只有2名（0.8%）血清转化。在可用于检测的1044份献血者标本中，16份（1.5%）有抗HCV抗体。9至12个月后对44名曾为血清阴性的有潜在关联的献血者重新检测时，仅又发现1名血清阳性献血者。在16名接受抗HCV阳性血液的受者中，14名（88%）发生了输血相关肝炎且抗HCV血清转化为阳性。其余两名受者既无肝炎也无抗HCV抗体。在对所有输注血液进行检测的25例非甲非乙型肝炎患者中，14例接受了抗HCV阳性的血液。
约90%有抗HCV抗体的献血者血液中有传染性病毒。对献血者进行抗HCV抗体筛查应可预防约一半的输血相关肝炎病例，但具有传染性病毒且抗HCV阴性的献血者可能长时间保持血清阴性。
