Post-transfusion NANBH in the light of a test for anti-HCV.
The incidence of post-transfusion hepatitis (PTH) varies over an order of magnitude in different parts of the world. For example, prospective studies from Spain and the UK reveal rates of PTH of approximately 10 and 0.5% respectively. Similarly the association of a history of transfusion in patients with chronic liver disease varies widely; in Japan, with high rates of PTH, the association appears obvious whereas in the UK less obvious. These factors must be taken into account when assessing the cost-effectiveness of pre-transfusion screening for anti-HCV. A useful approach to assessing the value of screening donors for anti-HCV is to study prospectively the correlation of anti-HCV and PTH. In carefully selected cases of PTH, the correlation of anti-HCV and PTH in donor-recipient sets of samples may be very high. However, the predictive value of 'first-generation' assays for anti-HCV in routine studies of unselected cases of PTH may be less than 20% in countries with low rates of transfusion-transmitted non-A, non-B hepatitis (NANBH). The anti-HCV screening tests and supplementary assays are continually evolving. More recent assays incorporate structural as well as non-structural antigens in both types of ELISA used for screening and in the supplementary tests such as the recombinant based immunoblots.(ABSTRACT TRUNCATED AT 250 WORDS)