Asunto(s)
Donantes de Sangre , Tamizaje Masivo/métodos , Técnicas de Amplificación de Ácido Nucleico/métodos , Virosis/diagnóstico , VIH-1/genética , Hepacivirus/genética , Humanos , Cooperación Internacional , Tamizaje Masivo/normas , Tamizaje Masivo/tendencias , Técnicas de Amplificación de Ácido Nucleico/estadística & datos numéricos , ARN Viral/sangre , Sensibilidad y Especificidad , Reacción a la Transfusión , Virosis/transmisiónRESUMEN
The recipients of blood components, from the first 12 anti-hepatitis C virus (HCV) positive donors identified by blood donor screening, 1985-1991, were traced retrospectively and tested to assess the HCV transmission rate, HCV genotypes and disease severity. Three enzyme-linked immunosorbent assay (ELISA) positive but RIBA-indeterminate and HCV RNA-negative donors did not transmit HCV to their 9 traced recipients. Nine RIBA- and HCV RNA-positive donors had donated blood to 27 now living recipients of whom 16/27 (59%) were viraemic 1-5 years later. Nine recipients had resolved infection, as determined by PCR HCV RNA. Five of these were RIBA-2 positive but HCV RNA-negative and 4 recipients were RIBA-2-indeterminate and HCV RNA-negative. Two recipients negative in all tests had probably received blood before the donor became infected with HCV. The HCV genotype in each case was identical between the donor and the recipient. Of the viraemic recipients, 50% (8/16) were unsuitable for further investigation or therapy due to their high age and/or underlying severe disease. At most, only 30% (8/27) of the recipients were suitable for further investigation and/or treatment. Two of these were already diagnosed as being infected with HCV before being traced. It is concluded that the benefit of a general tracing of recipients of blood components from HCV-infected donors is doubtful since only a few of them are suitable candidates for treatment. Our results seem to indicate that it is more appropriate to recommend anti-HCV testing to those seeking medical care who have received transfusions or undergone major surgery before 1992, i.e. before anti-HCV-screening was initiated.
Asunto(s)
Donantes de Sangre , Hepatitis C/transmisión , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Hepatitis C/terapia , Anticuerpos contra la Hepatitis C/sangre , Humanos , Interferones/uso terapéutico , Masculino , Persona de Mediana Edad , ARN Viral/análisis , Estudios RetrospectivosRESUMEN
Five of 72 patients dialysed at the same dialysis unit developed elevated alanine aminotranspherase (ALT) levels attributed to acute non-A, non-B hepatitis (NANBH). Histopathologic findings consistent with NANBH were present in four of them. Serological screening for antibodies to hepatitis C virus (anti-HCV) was performed in all 72 cases. Three of the patients with NANBH and 2 of the other 67 patients had positive tests. Low and transient levels of anti-HCV were noted in 2 patients with NANBH in spite of chronic hepatitis. Only 1 of 5 patients with NANBH was known to have had blood transfusions indicating other, as yet undefined, modes of transmission of HCV for the others. Although antibody responses to HCV might be transient or low, testing for anti-HCV should be considered in dialysis populations.