Published Date: 2004-04-02 23:50:00
Subject: PRO> Hepatitis C virus, blood supply - South Korea (02)
Archive Number: 20040402.0900
HEPATITIS C VIRUS, BLOOD SUPPLY - SOUTH KOREA (02)
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A ProMED-mail post
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International Society for Infectious Diseases
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Date: Fri 2 Apr 2004
From: Dr. Gregor Caspari <gregor.caspari@wtgmbh.de>
A Request for Clarification
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As a specialist in transfusion medicine, I have difficulty understanding
the background of the ProMED-mail post entitled: "Hepatitis C Virus, Blood
Supply - South Korea", archive number 20040330.0869. Concerning the 228
units of blood from 99 people suspected of being infected with human
immunodeficiency virus (HIV), it is likely that the screening EIA was
repeat reactive, and the immunoblot was negative. These people are
extremely likely not to be infected with HIV and are counseled accordingly!
Nevertheless, all countries I am aware of forbid transfusion of blood units
which are not unequivocally negative. Blood units are not unequivocally
negative if the screening EIA is repeat reactive. The theoretical risk is
that [though] the EIA is supposed to be somewhat more sensitive, there
might be a very short time period during which a recently infected person
may have a reactive EIA which cannot yet be confirmed by immunoblot.
Transfusing the EIA reactive units would mean breaking the rules, but it is
unlikely that the transfusion recipients were exposed to a significant risk.
If indeed 76 677 units of blood from hepatitis C virus-infected donors had
been distributed for transfusion, then it is difficult to believe that only
8 recipients were infected. Reference to the donors' disease history could
possibly mean that the donors for these 8 infected recipients had hepatitis
C virus infection in the past, and that they lost their antibodies but were
still infectious in subsequent donations. It could mean that disease
history of hepatitis (which is different from hepatitis virus infection)
was ignored.
In Germany, any donor with unexplained hepatitis in the past is excluded
from blood donation on a permanent basis. It is unlikely that this applies
for the cases described, because hepatitis due to hepatitis C virus
infection should be positive in the infectious disease tests most of the
time. Donors might have been in the serologic window phase of early
infection, which is only recognizable with nucleic acid amplification
tests. If these were not done, the presence of a small percentage of
infectious donors in the serologic window phase would have been
unavoidable, and hence, there would be no failure.
Screening could have been performed improperly, but then the comment on
donors' history would make no sense. Could anyone state more clearly what
in fact has happened in South Korea?
--
Dr. Gregor Caspari
Institut fur Transfusionsmedizin
W & T GmbH
Hochstr. 29
14770 Brandenburg an der Havel
Germany
<gregor.caspari@wtgmbh.de>
[ProMED-mail suggests that, anyone who can provide clarification should
address their comments directly to Dr. Caspari. - Mod.CP]
See Also
Hepatitis C virus, blood supply - South Korea 20040330.0869CJD (new var.), blood supply - UK 20040318.0758
2003
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West Nile virus update 2003 - USA (25) 20030918.2368
Hepatitis B virus, blood transfusion, 2003 - Japan 20030914.2326
Hepatitis B virus, blood transfusion, 2000 - Japan (03) 20030826.2149
HIV, hepatitis, syphilis contamin. blood - Japan (02) 20030821.2098
West Nile virus update 2003 - USA (20) 20030815.2034
CJD (new var.), blood transmission - UK: susp 20031217.3082
CJD (new var.), blood transmission - UK: susp (02) 20031219.3095
2002
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West Nile virus, transplant transmission - USA (03) 20020909.5269
..........................cp/msp/dk
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