What is the risk of transfusion-transmitted HCV infection?

Updated: Jan 15, 2017
  • Author: Mudassar Zia, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Answer

The hepatitis C virus (HCV) is a spherical, enveloped, single-stranded RNA virus belonging to the Flaviviridae family. The World Health Organization (WHO) estimates that 170 million individuals worldwide are infected with HCV, with a wide variation in the prevalence of the disease. For example, in 2000, Frank et al reported that Egypt had the highest number of reported HCV infections, largely attributed to the use of contaminated, parenteral, antischistosomal therapy. [34] This led to a mean 22% prevalence of HCV antibodies in persons living in Egypt. According to the CDC, an estimated 1.8% of the US population is positive for HCV antibodies. [22, 26, 35]

HCV is predominantly transmitted by means of percutaneous exposure to infected blood. In developed countries, most new HCV infections are related to intravenous (IV) drug abuse and are found because of intensive screening and lookback programs.

Blood transfusion was a major risk for acute HCV infection in the past, with more than 10% of transfusion recipients acquiring the infection in some studies. [25] The screening of blood donors by donor history and elevated serum alanine aminotransferase (ALT) caused a striking reduction of non-A, non-B posttransfusion hepatitis, even before HCV was identified. The subsequent initiation of donor screening for anti-HCV antibodies in 1990 nearly eliminated the risk of posttransfusion acute HCV infection. [25]

Indeed, such screening has decreased the risk of transfusion-associated HCV infection to less than 1 case in 103,000 transfused units. [18, 19, 20, 35]


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