Prevalence and epidemiological characteristics of hepatitis C in Scottish blood donors

Abstract

All blood donors in Scotland who were found to be infected with hepatitis C virus (HCV) in the first 6 months of routine testing of all donations for anti-HCV were contacted. Those who attended were counselled, a history of exposure to risk was sought, and blood was taken for alanine aminotransferase (ALT) level as a measure of liver function. The epidemiological features were then correlated with the virological findings and ALT. In the period under study between September 1991 and February 1992, 180,658 blood donors attended. The prevalence of HCV infection was 0.088%. Of the 151 donors who attended for counselling, 101 (68%) were male. Intravenous drug use was the most common risk activity (39%), followed by previous blood transfusion (15.2%), other parenteral exposure (11.2%) and heterosexual contact with a parenterally infected partner (8.6%); 29.1% of donors gave no history of possible exposure. Elevated ALT levels were found in 59%. ALT levels were higher in donors with HCV types 1 and 3 than in HCV type 2 or non-viraemic donors. The prevalence of HCV in Scottish blood donors is thus relatively low. This may relate to the effectiveness of donor selection procedures, but donors with risk activities which should debar them continue to donate. The combination of ALT and PCR appears to be useful in counselling and assessing infected donors.

Hepatitis C Virus: Routes of Infection and Genotypes in a Cohort of Anti-HCV-Positive French Blood Donors

“…We confirm that 1b is the most prevalent genotype among European donors [12]and patients [13], followed by 3a. We also found that IVDU and a history of blood transfusion are the main routes of HCV transmission, as observed in French studies [14, 15]and in other European countries [16, 17]. Genotype 1b seems to correlate with blood transfusion, and 1a and 3a strongly with IVDU [13, 18].…”

“…Those infected with genotypes 3a, and less often 1a, are more likely to have high ALT levels than those with other genotypes, as already observed [17]. …”

Percutaneous Route as a Risk Factor for Seropositivity of Hepatitis C Virus Infection

“…11 With only history of multiple sex partners present in 8.16% anti HCV positive cases sexual promiscuity was the other risk factor. A role for sexual transmission was suggested by studies of Crawford et al, 16 Luksamijarulkul et al, 20 and Brandao et al 22 The present study highlighted an important fact that exposure through minor percutaneous routes of transmission like tattooing and sharing of shaving kits or visit to road side barber along with multiple unsafe intravenous injections may have played an important role in HCV transmission in our blood donors. Therefore a need arises not only to routinely screen the blood donors for HCV but also to educate them about the modes of spread of this dangerous but preventable disease.…”

“…drug use present in 28.57% cases who gave a history of prolonged hospitalization or receiving multiple injections from quacks. IV drug use was found to be most common risk factor also by Crawford et al, 16 and Similarly Khattak et al 17 and Akhtar et al 18 revealed that positive donors had a history of past hospitalization or multiple injections.…”

A Second Outbreak of Hepatitis C Virus Infection from Anti–D Immunoglobulin in Ireland

“…Low levels of infectivity in blood products and the absence of consistent symptoms in recipients may prevent the identification of other common–source outbreaks of HCV infection. Such unrecognised outbreaks may contribute to the 30–50% of HCV–infected individuals identified on screening with no obvious risk factors for infection [17, 18, 19]. …”