Frequency and characteristics of post‐transfusion hepatitis in Greece with emphasis on hepatitis C: comparing second‐ and third‐generation assays

SUMMARY. In order to evaluate the role of hepatitis C virus (HCV) in post-transfusion hepatitis (PTH) in Greece we prospectively followed 143 transfusion recipients, receiving 790 units of blood and/or products from 789 donors, between October 1989 and December 1991. The mean number of units transfused per patient was 5–52. PTH was observed in 18 patients (12–59%). One patient (0–70%) developed hepatitis B, in four (2–80%) hepatitis could be attributed to CMV infection, 10 (6–99%) developed hepatitis C and three (2–10%) showed only raised alanine aminotransferase (ALT) levels. The risk of PTH per 1000 units transfused was 22–8. The patient who developed hepatitis B (PTH-B) was transfused with four units, one of which was positive for anti-HBc and anti-HBe. Seven of the 10 patients (70%) who developed hepatitis C (PTH-C) were transfused with at least one unit seropositive in the anti-HCV screening with 2nd-generation tests (ELISA-2 and RIBA-2), whereas 9/10 of PTH-C cases (90%) were transfused with at least one unit positive in 3rd-generation assays. Of the three patients who showed only ALT elevation, none was transfused with anti-HCV seropositive blood, although one of them was transfused with at least one unit with elevated ALT levels. We conclude that: (1) the incidence of PTH in Greece remains high, (2)screening of all donations for anti-HCV with an ELISA-2 does not exclude transmission of HCV and (3) ELISA-3 and RIBA-3 seem to be more sensitive in blood donor screening and in detecting seroconversions than ELISA-2 and RIBA-2.