Transfusion medicine
Transfusion transmitted disease
Hepatitis C and transfusion

Topic Completed: 1 October 2011

Revised: 8 April 2019

Copyright: 2002-2019,, Inc.

PubMed Search: Hepatitis C [title] transfusion [title] "loattrfree full text"[sb]

Huy Phu Pham, M.D., M.P.H.
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Cite this page: Pham HP Hepatitis C and transfusion . website. Accessed June 20th, 2019.
Definition / general
  • Hepatitis C virus is an RNA virus
  • Transmitted parenterally, especially through blood transfusions (before testing) and intravenous drug use
  • Historical risk for "non-A, non-B hepatitis" was 7% from volunteer donated blood and 28% from commercial blood
  • 9% of Chinese patients with HCV due to unscreened blood have developed cirrhosis after a mean of 13 years (Zhonghua Gan Zang Bing Za Zhi 2006;14:199)
  • Recommended to offer screening to patients (particularly children) who received blood products in 1992 (U.S.) or previously, when blood was not screened for HCV (Acta Paediatr 2007;96:1050, Transfusion 2007;47:615, Transfusion 2005;45:1020)
  • Serologic testing and nucleic acid based testing have reduced risk, although developing countries may not screen (J Hepatol 2006;45:607)

In the U.S.:
  • In 1970s, 10% of blood transfusion recipients had evidence of hepatitis C
  • With current NAT testing, the risk of transfusion transmitted hepatitis C infection is 1:1.4 million products
  • Documented breakthrough cases from nonreactive nucleic acid testing components are rare (Lancet 2000;355:41)
  • Yield of HCV look back in Canada is likely zero when prior donations were tested by second or third generation EIA (Transfusion 2006;46:690)
  • Identified in 1 per 250,000 donors in U.S. (Arch Pathol Lab Med 2007;131:702)
  • Donors are usually asymptomatic
  • Risk factors are injection drug use, hemodialysis, incarceration, receipt of blood products prior to HCV testing
  • Also ozone enriched transfusion of autologous blood in Italy (Infect Control Hosp Epidemiol 2005;26:762)
  • Antigen positive donors may not seroconvert (Transfusion 2000;40:1280)
  • Pathogen inactivation has eliminated transmission in U.S. licensed plasma derivatives since 1985; however technique cannot be used for cellular components (Arch Pathol Lab Med 2007;131:719)
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