Detection of a healthy carrier of HCV with no evidence of antibodies for over four years

BACKGROUND: Posttransfusion HCV has been notably reduced over recent years as a result of the systematic testing for antibodies to HCV in blood donors. However, the risk of transfusing blood-derived components from virus-carrying donors still remains. A diagnosis is reported here of HCV in a regular blood donor who had no antibodies during the entire time she was followed up. CASE REPORT: The pharmaceutical company responsible for fractioning the plasma detected a donor who was a carrier of HCV, confirmed by PCR, but whose tests to detect anti-HCV were systematically negative. The donor had given blood on five previous occasions, from which 14 components were manufactured. Of the 11 components traced, six had been transfused, and in the two cases in which study of the anti-HCV was possible in the recipients, the result was positive. It was possible to check the blood samples from the donor from May 1997 to March 2002 (58 months). The tests to detect anti-HCV were all negative, while the PCR and core antigen tests were positive. CONCLUSION: The incorporation of RNA detection or HCV core antigen techniques in blood banks may reduce the residual risk of contracting posttransfusion HCV. Measures such as the correct traceability of the components, the existence of a specimen bank, or follow up of the recipients of blood-derived components would help to improve the quality of blood banking with percentage of survivability and case investigations.