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Transfusion medicine

Tranfusion-transmitted disease

Hepatitis C and transfusion

Reviewer: Huy Phu Pham, M.D. (see Reviewers page)
Revised: 4 November 2011, last major update October 2011
Copyright: (c) 2007-2011, PathologyOutlines.com, Inc.


● 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 mean 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 (US) 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 1970's, 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 250K donors in US (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 US licensed plasma derivatives since 1985; however technique cannot be used for cellular components (Arch Pathol Lab Med 2007;131:719)
Additional references: Nature Medicine 2000; 6:1082 (history), eMedicine

End of Transfusion Medicine > Tranfusion-transmitted disease > Hepatitis C and transfusion

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