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Antibody to Hepatitis C Virus in Post-Transfusion Hepatitis

Federico Tremolada, MD; Carla Casarin, MD; Alessandro Tagger, PhD; Maria Luisa Ribero, PhD; Giuseppe Realdi, MD; Alfredo Alberti, MD; and Arturo Ruol, MD
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Grant Support: In part by a grant from The Italian Ministry of University and Scientific Research and by a grant from the National Research Council.

Requests for Reprints: Alfredo Alberti, MD, Institute of Clinical Medicine, Via Giustiniani 2, 35128 Padua, Italy.

Current Author Addresses: Dr. Tremolada: Department of Experimental and Clinical Medicine, University of Reggio Calabria, 88100 Catanzaro, Italy.

Drs. Casarin, Alberti, and Ruol: Institute of Clinical Medicine, University of Padua, 35128 Padua, Italy.

Drs. Tagger and Ribero: Institutes of Virology and Hygiene, University of Milan, 22100 Milan, Italy.

Dr. Realdi: Institute of Clinical Medicine, University of Sassari, 07100 Sassari, Italy.

© 1991 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1991;114(4):277-281. doi:10.7326/0003-4819-114-4-277
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Objective: To evaluate the prevalence of antibodies to hepatitis C virus (anti-HCV), their relation to outcome, and the seroconversion rate in patients with post-transfusion non-A, non-B hepatitis.

Design: Retrospective analysis of prospectively collected serum specimens.

Setting: A referral-based university hospital.

Patients: Sixty-three consecutive patients who developed non-A, non-B post-transfusion hepatitis after open-heart surgery. All patients had follow-up with serial serum testing and clinical evaluation. The mean (± SD) duration of follow-up after hepatitis onset was 81 ±33 months (range, 13 to 132 months). Seventeen patients recovered after acute-phase illness, whereas 46 developed chronic disease which, in 30 cases, was confirmed histologically.

Main Results: Of 32 patients tested before transfusion, 1 (3.1%) had anti-HCV. Fifty-nine (93%) patients were anti-HCV positive during acute-phase hepatitis: Patients with "early" seroconversion (< 15 days after hepatitis onset) did not differ from those with "late" seroconversion (> 60 days after onset) in epidemiologic, clinical, and biochemical features. The rate of anti-HCV positivity during acute-phase illness was not significantly different among patients who recovered (76%) compared with those who developed chronic disease (95%). At 6 to 12 months, patients whose disease resolved had lower antibody activity than those with progressive disease. Further, during long-term follow-up (1 to 9 years), 53% of patients whose disease resolved but only 6.9% of patients who had progressive disease became anti-HCV negative.

Conclusions: Hepatitis C virus is the major cause of post-transfusion hepatitis in Italy. The time to anti-HCV seroconversion varies widely after hepatitis onset and is not significantly associated with acute-phase features or outcome of disease.





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