Laboratory diagnosis and molecular epidemiology of an outbreak of hepatitis C virus infection among recipients of human intravenous immunoglobulin in Spain

Abstract

The results did not exclude the possibility that a second HCV strain associated with a further, unidentified batch of the IVIG could have contributed to this outbreak.

Typing of Hepatitis C Virus Antibody with Specific Peptides in Seropositive Blood Donors and Comparison with Genotyping of Viral RNA

“…These last two ge notypes are prevalent in Africa and genotype 6 is often found in the Far East [2]. Moreover, genotype 3 seems to be more prevalent among intravenous drug users (IVDU) than among blood donors in Southern Europe [3], Recently, three additional HCV genotypes (7)(8)(9) have been reported from South-Eastern Asia [4].…”

Managing Occupational Risks for Hepatitis C Transmission in the Health Care Setting

“…In addition, in one series of experiments, neither anti-HCV-negative intravenous immunoglobulin nor immunoglobulin that contained high-titered antibody directed against hepatitis C administered 1 h after exposure to HCV-containing blood prevented transmission of HCV infection in chimpanzees (183). Finally, it should be noted that administration of intravenous immunoglobulin preparations has been incriminated as transmitting HCV in Spain, France, Italy, Scandinavia, the United Kingdom, and the United States (32, 38, 43, 52, 61, 68,93,108,114,128,141,142,163,164,197,203,226,240,272,276,288,298,369,370,373). Newer approaches, such as solvent or detergent treatment and heating at low pH, have reduced the risk of HCV transmission from these products (37, 58, 289), but the clusters of infection linked to intravenous immunoglobulin treatment clearly underscore the lack of value of immunoglobulin as postexposure prophylaxis.…”

“…In addition to clusters of HCV infections in the hemodialysis setting, cases and outbreaks of hepatitis C infection have been linked to a variety of medical procedures and interventions, including the use of spring-loaded finger stick devices (81,247), gynecological and gynecologic endocrinologic procedures (200,211,263,287), contamination of multidose vials (182,186,211,312,348,365), contaminated intravenous administration devices (299), orthopedic procedures (286), cardiothoracic surgery (41, 90, 97), anesthesiologist's and anesthesia assistant's interventions (71,143,285), endoscopy (228), colonoscopy (40), administration of contaminated immunoglobulin preparations (61, 93,171,191,192,288,317), organ transplantation (367), and outbreaks that were clearly nosocomial yet for which no etiology could be determined (178,188,290). Some, if not most, of these instances of HCV transmission most likely represent cross-contamination, due, at least in part, to inadequate infection control procedures or inadequate disinfection of devices or objects (40,81,143,186,200,211,228,247,292,299,312,348,365); others appear to be direct, provider-to-patient transmission (discussed in detail below).…”

Use of Bovine Viral Diarrhoea Virus as an Internal Control for Amplification of Hepatitis C Virus

“…By detecting the virus itself rather than the specific immune response to it, it plays a complementary role to serology in laboratory diagnosis of infection and in the screening of blood donors for infection with hepatitis C virus (HCV), human immunodeficiency virus type 1 (HIV–1) and hepatitis B virus. Indeed, concerns about the efficacy of relying solely on the serological detection of antibody to HCV and HIV–1 have arisen following the recently described cases of transmission of HCV through the use of immunoglobulins prepared from antibody–screened plasma [1, 2, 3]and the sporadic cases of transmission through the transfusion of red cells and platelets.…”