THE DECLINING RISK OF POSTTRANSFUSION HEPATITIS-C VIRUS-INFECTION
THE DECLINING RISK OF POSTTRANSFUSION HEPATITIS-C VIRUS-INFECTION
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DOI：
10.1056/nejm199208063270601
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发表时间：
1992-08-06
影响因子：
158.5
通讯作者：
NELSON, KE
中科院分区：
文献类型：
--
作者：
DONAHUE, JG;MUNOZ, A;NELSON, KE
背景输血最常见的严重并发症是丙型肝炎病毒（HCV）引起的输血后肝炎。血库现在筛查献血者的非甲、非乙型肝炎的替代标志物和HCV抗体，但目前输血后丙型肝炎的风险尚不清楚。从1985年到1991年，前瞻性地从心脏手术前和术后至少6个月的患者中获得血液样本和医疗信息。用酶免疫法检测血清标本中的HCV抗体，阳性者用重组免疫印迹法检测。在912名在捐献者之前接受输血的患者中，有35名患者血清转化为HCV，每名患者的风险为3.84%（每单位输血0.45%）。对于1986年10月以后接受输血的976例患者，血液筛查替代标志物，血清转化的风险为每例患者1.54%（每单位0.19%）。对于自1990年5月增加HCV抗体筛查以来接受输血的522名患者，风险为每名患者0.57%（每单位0.03%）。随着供体筛选的日益严格，风险降低的趋势具有统计学意义（P
Background. The most common serious complication of blood transfusion is post-transfusion hepatitis from the hepatitis C virus (HCV). Blood banks now screen blood donors for surrogate markers of non-A, non-B hepatitis and antibodies to HCV, but the current risk of post-transfusion hepatitis C is unknown.Methods. From 1985 through 1991, blood samples and medical information were obtained prospectively from patients before and at least six months after cardiac surgery. The stored serum samples were tested for antibodies to HCV by enzyme immunoassay, and by recombinant immunoblotting if positive.Results. Of the 912 patients who received transfusions before donors were screened for surrogate markers, 35 seroconverted to HCV, for a risk of 3.84 percent per patient (0.45 percent per unit transfused). For the 976 patients who received transfusions after October 1986 with blood screened for surrogate markers, the risk of seroconversion was 1.54 percent per patient (0.19 percent per unit). For the 522 patients receiving transfusions since the addition in May 1990 of screening for antibodies to HCV, the risk was 0.57 percent per patient (0.03 percent per unit). The trend toward decreasing risk with increasingly stringent screening of donors was statistically significant (P