[Screening for post-transfusion hepatitis C-importance of enrollment and recall of blood transfusion recipients].

OBJECTIVE

To detect chronic hepatitis C virus infection in recipients of blood products.

DESIGN

Retrospective analysis by recall and enrollment of recipients.

PATIENTS AND METHODS

Two-hundred twenty-six patients who received blood products in Tokushima for open heart surgery from January 1993 to December 1992 were examined for HCV antibodies by second-generation assay and surrogate markers.

RESULTS

Twenty two (14%) of the 161 patients who received blood products before Nov 1989 had detectable HCV antibodies, but none of the 65 recipients receiving blood after 1990, the year the blood bank began to screen for HCV-antibody. Of 22 seropositive patients, HCV RNA (ribonucleic acid) was recognized in 10 (45%) by HCV PCR (polymerase chain reaction) method, indicating persistent HCV infection. Moreover, abnormal alanine aminotransferase (ALT), more than 25 IU/l, during the chronic phase of HCV infection was recognized in 9 of 10 patients with detectable HCV RNA, but none in patients with undetectable HCV RNA. In the 15 patients in whom liver biopsy was performed, 10 had abnormal histology; 4 chronic active hepatitis, 6 chronic persistent hepatitis, and 5 had normal histology.

CONCLUSION

It is Important to recall and screen for chronic hepatitis C In blood product recipients, since persistent and active HCV infection is often assymptomatic, yet treatable.