The usefulness of surrogate markers anti-HBc and ALT for post-transfusion non-A, non-B hepatitis prevention.

Non-A, non-B hepatitis represents an important problem for public health throughout the world. For several years, Transfusion Centers have been looking into improvements for more efficiently preventing post-transfusion non-A, non-B hepatitis. The viruses involved in such a pathology have not yet been isolated and no specific marker is available for direct screening and prevention. Surrogate markers, alanine aminotransferase and anti-HBc antibody have been evaluated by different teams, however, for this purpose. Fifty or 60% of transfusion-related non-A, non-B hepatitis could be prevented thanks to these markers, but such a strategy would induce a high loss of blood products. Therefore, a compromise must be found between quality objectives and economical costs, generated by this procedure. The social and financial costs of chronic hepatitis for the public health would be balanced by costs involved in such a screening policy and therefore Transfusion Centers should probably initiate this quality improvement using one or both tests in the near future.