Incidence of non-A, non-B hepatitis after screening blood donors for antibodies to hepatitis C virus and surrogate markers
Article Abstract:
A common cause of hepatitis or liver inflammation is infection by a virus. For many years, blood transfusions were a major cause of viral hepatitis. Hepatitis A and hepatitis B viruses have been identified, and donated blood that is contaminated with either virus is rejected rather than transfused. Transfusion recipients have continued to develop hepatitis that appears to be of viral origin, but because no other virus was identifiable, this type of hepatitis was designated non-A, non-B hepatitis. In recent years, a virus named hepatitis C virus has been identified, and is generally believed to be the cause of most cases of non-A, non-B hepatitis. Antibodies to hepatitis C virus (anti-HCV) can now be detected by a blood test, and it has been suggested that donated blood should be tested for anti-HCV. If the latter is present, the blood should be rejected for transfusion because of the high risk of post-transfusion hepatitis in recipients. A study was conducted to determine the usefulness of such anti-HCV testing. Two hundred and fifty persons who had received blood transfusions were examined to determine the incidence of post-transfusion hepatitis; the blood of the donors was tested for anti-HCV antibodies. Non-A, non-B hepatitis was diagnosed in 40 of the 250 recipients. Five of these patients were found to have anti-HCV antibodies before their transfusions, and 30 of the remaining 35 were found to have developed anti-HCV antibodies after transfusion. Comparison to donors' blood revealed that 34 of the 40 who developed post-transfusion hepatitis had received blood with anti-HCV antibodies. By contrast, only 2 of 210 persons who had received donor blood without anti-HCV antibodies developed post-transfusion hepatitis. The risk of developing post-transfusion hepatitis is 20 times greater when the donor's blood has anti-HCV antibodies than when it does not. The fact that a few persons developed post-transfusion hepatitis even when the matched donors' blood was negative for anti-HCV antibodies suggests that the test for those antibodies is not as sensitive as it might be. However, the results are sufficiently convincing to conclude that donated blood should be tested for antibodies to hepatitis C virus. This step should significantly reduce the incidence of post-transfusion hepatitis. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1991
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Descartes before the horse: I clone, therefore I am: the hepatitis C virus in current perspective
Article Abstract:
Hepatitis C virus has only recently been identified. This virus is currently the leading cause of transfusion-associated hepatitis. Its existence has long been suspected, because of the relatively high incidence of transfusion-associated hepatitis, formerly designated non-A, non-B hepatitis (because neither the hepatitis A nor B virus was identified in the blood of the donors). Reversing the typical process of identifying a new virus, the hepatitis C virus was cloned, or reproduced in a test tube, before its structure was known. Once the virus was successfully identified, it was possible to measure antibodies to it in the blood of those with the disease. The relation between hepatitis C with blood transfusion was quickly established. Because some cases have occurred in those who have never had a transfusion, other means of transmission are known to exist, but what these other methods are is not clear. Some evidence exists for sexual transmission, because some sex partners of those with the disease also carry the virus, but the incidence is much lower than for hepatitis B, which is well known to be transmitted sexually. The earliest commercial test kits for detecting the hepatitis C virus and its antibodies were not as sensitive as might be preferred, but recent test kits are more reliable. As the tests are improved, they will be able to screen donated blood with hepatitis C virus much more effectively, and thus decrease the incidence of transfusion-associated hepatitis considerably. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1991
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Hepatitis C virus infection in patients with nonalcoholic chronic liver disease
Article Abstract:
Hepatitis is an inflammatory condition of the liver and can result in death or in temporary or permanent impairment of liver function. This condition can be caused by bacteria, drugs, alcohol, transfusions of incompatible blood, or by viruses. Hepatitis A and B are known to be caused by viruses. It has long been suspected that infection with non-A, non-B hepatitis virus, now called hepatitis C virus, is a common cause of chronic liver disease. Recently, a method has been developed that allows the levels of antibodies against the hepatitis C virus to be measured. Antibodies are globular proteins produced by the immune system which bind and inactivate foreign substances such as viruses. To ascertain the extent of infection with hepatitis C virus and its importance in nonalcoholic chronic liver disease, 346 patients with chronic liver disease and 1,495 healthy blood donors were screened for antibodies against hepatitis C virus. Eighty-two percent of the patients with chronic liver disease of unknown cause had antibodies against the hepatitis C virus, and levels were higher in those patients who had received blood transfusions. In patients with chronic hepatitis B, 11 percent had antibodies against the hepatitis C virus, but in healthy blood donors, only one percent had antibodies against the hepatitis C virus. Hepatitis C virus may be a causative factor in the development of chronic liver disease of unknown origin, and may also be involved in the development of hepatitis B. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1990
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