EFFICACY OF SCREENING DONORS FOR ANTIBODIES TO THE HEPATITIS-C VIRUS TO PREVENT TRANSFUSION-ASSOCIATED HEPATITIS - FINAL REPORT OF A PROSPECTIVE TRIAL

被引:34
作者
GONZALEZ, A
ESTEBAN, JI
MADOZ, P
VILADOMIU, L
GENESCA, J
MUNIZ, E
ENRIQUEZ, J
TORRAS, X
HERNANDEZ, JM
QUER, J
VIDAL, X
ALTER, HJ
SHIH, JW
ESTEBAN, R
GUARDIA, J
机构
[1] HOSP GEN VALLE HEBRON,DEPT INTERNAL MED,LIVER UNIT,E-08035 BARCELONA,SPAIN
[2] HOSP GEN VALLE HEBRON,CLIN PHARMACOL UNIT,E-08035 BARCELONA,SPAIN
[3] INST CATALA SALUT,BLOOD BANK,BARCELONA,SPAIN
[4] UNIV AUTONOMA BARCELONA,HOSP SANTA CRUZ & SAN PABLO,BLOOD BANK,BARCELONA,SPAIN
[5] UNIV AUTONOMA BARCELONA,HOSP SANTA CRUZ & SAN PABLO,GASTROENTEROL UNIT,BARCELONA,SPAIN
[6] NIH,WARREN GRANT MAGNUSON CLIN CTR,DEPT TRANSFUS MED,BETHESDA,MD
关键词
D O I
10.1002/hep.1840220211
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Routine screening of blood donors for anti-hepatitis C virus (HCV) has been implemented in most developed countries. However, the independent efficacy of such screening has not been established in a controlled, prospective study. We tracked 478 patients transfused with anti-HCV-negative blood by first-generation enzyme-linked immunoassay (EIA) between July 1989 and May 1990 and compared the incidence of transfusion-associated hepatitis and HCV infections with that found among 280 patients transfused with blood unscreened for anti-HCV during the immediately preceding year. Of the 280 patients who had received transfusions before donors were screened for anti-HCV, 27 (9.6%) developed posttransfusion hepatitis and 1 additional patient sero-converted to anti-HCV without evidence of hepatitis, for a risk of posttransfusion HCV infection of 10.7% (28 of 262 recipients seronegative for anti-HCV before transfusion). Of the 478 patients transfused after July 1989 with blood screened for anti-HCV, only 9 (1.9%) developed posttransfusion hepatitis for a risk reduction of 80%. Seven of the 9 residual cases of hepatitis were caused by HCV (7 of 456 recipients seronegative before transfusion or 1.5%) for a risk reduction of transfusion-associated HCV infection of 86%, in retrospect, an anti-HCV positive donor was detected by second-generation immunoassay in 4 (57%) of the 7 HCV cases from the study cohort and in 19 of the 23 (83%) cases from whom all donor samples were available for testing in the historical cohort. No additional infectious donors were detected by third-generation immunoassay or serum HCV-RNA by polymerase chain reaction. implementation of donor screening for anti-HCV with a first-generation immunoassay appeared to be independently associated with an 80% and 86% reduction in the risks of transfusion-associated hepatitis and HCV infection, respectively. Screening of donors with second-generation immunoassays might have further reduced the risk by 57%. An additional 0.4% may be at risk of developing non-A, non-B, non-C hepatitis.
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页码:439 / 445
页数:7
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