Blood Transfusion Clinical Trial
To determine the risk of transfusion-transmitted hepatitis C virus (HCV) in cardiac surgery patients before and after donor screening for anti-HCV and surrogate markers of non-A, non-B hepatitis (NANBH). Also, to characterize donors who were HCV seronegative and who lacked surrogate markers at the time of donation, but whose recipient seroconverted to HCV.
BACKGROUND:
In the early 1990s, posttransfusion NANBH, mainly caused by HCV, was the most common serious
complication of transfusions, occurring in 2-5 percent of transfusion recipients. About 50
percent of those infected developed chronic hepatitis, of whom, 10 to 20 percent developed
cirrhosis. Hepatocellular carcinoma had been reported to occur in some. This study provided
the first evaluation of the effectiveness of donor screening for anti-HCV by the then
recently licensed HCV antibody test and surrogate markers of NANBH. It also provided a
precise estimate of the risk of transfusion-transmitted HCV. The results allowed examination
of risk factors for HCV infected donors who were seronegative at the time of donation.
DESIGN NARRATIVE:
The study was a nonconcurrent prospective, seroepidemiologic study. To estimate the
incidence of HCV infection, six-month postoperative serum samples were tested for antibody
to HCV. Preoperative samples corresponding to positive postoperative sera were also tested.
The donors of a patient who received blood screened for HCV, i.e., a donation since May,
1990, and seroconverted in the six months since transfusion were located and retested for
antibodies to HCV. The donors were administered a questionnaire designed to ascertain risk
factors for HCV infection. A sample of donors who were HCV positive at the time of donation
were given the same questionnaire. Comparison of these three groups of donors (i.e.,
seropositives, donors tested negative but implicated in seroconversion, seronegatives)
allowed an investigation of factors associated with false negative screening results.
Analytical methods included standard methods for contingency tables and both conditional and
unconditional logistic regression.
The study completion date listed in this record was obtained from the "End Date" entered in
the Protocol Registration and Results System (PRS) record.
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