Prevention of posttransfusion hepatitis by screening with second-generation anti-HCV antibody and clinical features of HCV infection.

After adaptation of the second-generation anti-hepatitis C virus (HCV) test, the incidence of post-transfusion hepatitis (PTH) resulted in 5.2% (11/208), which was significantly lower than that 10.5% (22/209) demonstrated by screening donor blood for C100-3 antibody. The 11 cases of PTH, three were classified as definite PTH and the other were as suspected one. Of two cases with definite PTH and two cases with suspected PTH, their blood samples after transfusion became positive for HCV-RNA, and three cases of those showed a second peak of alanine aminotransferase (ALT) more than 4 weeks after operation. On the other hand, of seven cases containing one definite PTH, their blood samples after transfusion became negative for HCV-RNA, and five cases of those showed ALT peaks within 4 weeks after operation, and returned to normal levels of ALT thereafter. Moreover, in cases of definite PTH, the periods of surgery and anesthesia were longer and the volume of bleeding was much more during operation than in cases of suspected PTH, although the differences were not statistically significant. These findings suggested that cases of PTH include those of transient liver disease attributable to surgery as well as those of HCV infection. In 11 cases of PTH, we consider that 2 cases is true PTH, because these are HCV-RNA positive and have second peak more than 4 weeks after operation and 5 cases is questionable by clinical date. Thus new diagnostic criteria should have established.