Hepatitis C Virus In Blood Donors Research Articles

Seroprevalence of Human Immunodeficiency Virus, Hepatitis C Virus, and Hepatitis B Virus Among Blood Donors in Sidi Bel Abbes, West Algeria.

Introduction Blood transfusions can transmit various viruses. Among them, the most common are hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). These viruses can cause fatal and life-threatening diseases. Worldwide, many people are infected with these viruses. Blood safety has made majorprogress in recent years. Yet, blood-borne viruses continue to be a major concern for patients, physicians, and policymakers. The aim of this study was to assessthe prevalence of HIV, HBV, and HCV in blood donors. Methods A cross-sectional study was performed to assess HIV, HBV, and HCV seropositivity in blood donors. This research was carried out at the blood bank of Sidi Bel Abbes University Hospital. This was a retrospective study based on records of blood donors. All data of 10,386 donors were analyzed from January 2015 to December 2015. Biological screening was performed by enzyme-linked immunosorbent assay (ELISA) using antibodies and/or antigens. The combined HCV and HIV antigen and antibody ELISA test was utilized. To confirm the results, the blood bank and the virology laboratory used the same technique in duplicate. Results The overall seroprevalence of blood-borne viral infections (HIV, HBV, and HCV) in blood donors was 0.8%. The prevalence of HIV was found to be 0.1%, while the prevalence of HBV and HCV was 0.4%. Coinfection was rare with only one case of HBV with HIV.There was a significant difference in seroprevalence rates among blood donors compared to the general population. Significant variations were observed between the prevalence of this study and those conducted in West, East, Central, and South African countries but not with those of neighboringNorth African countries. The study found no association between seropositivity in blood donors and factors like age, gender, donor status, type of donation, or site. Besides, HIV, HBV, or HCV prevalence was not influenced by ABO and Rhesus blood group. Conclusion The study showed that blood donors in Algeria have a lower prevalence of blood-borne viral infections than the general population. The seropositivity rate of viral markers was similar throughout North African countries. This rate remained low compared to other African countries. Residual risk of infection persists. There is a need to increase blood safety for recipients. This report is the first comprehensive overview of blood-borne viruses among Algerian blood donors. There is a need for further nationwide studies to get a whole picture of the situation.

Seroprevalence of hepatitis C virus in voluntary blood donors at a tertiary care hospital, Ahmedabad, India

Background: Hepatitis C virus (HCV) is the most common cause of post transfusion non-A, non-B hepatitis worldwide. The prevalence of HCV in blood donors in high-income countries ranges from 0.002% to 0.05%, in middle-income countries ranges from 0.03% to 0.80%, and in low-income countries, prevalence varies from 0.50% to 2.23%. Objectives: The objectives of this study are to assess the seroprevalence and the trend of HCV in healthy voluntary blood donors at a tertiary care hospital in Ahmedabad over a period of 3 years. Settings and Design: Observational, retrospective study. Materials and Methods: During January 2017 to December 2019, 9477 voluntary blood donors were tested for the presence of anti-HCV antibody by using a 3rd-generation enzyme-linked immunosorbent assay test. Statistical Analysis Used: Data were statistically analyzed by using the Chi-square test, and Chi-Square test for linear trends using the Statistical Package for the Social Sciences (SPSS) software trial version 19. Results: Out of 9477 voluntary blood donors, 9229 (97.38%) donors were male and 248 (2.62%) were female. Ten donors (0.11%) were positive for anti-HCV. All seropositive donors were male. Out of total 0.11% seropositive donors, maximum (0.07%) were within the age group of 21–30 years. Seroprevalence of HCV showed a statistically significant decreasing trend over 3 years. Conclusion: Hepatitis C is a common cause of transfusion-related hepatitis. Early identification of persons with chronic HCV infection would enable infected persons to receive the necessary care and treatment to prevent or delay the onset of liver disease.

Sero-prevalence of transfusion transmittable infections: HIV, Hepatitis B, C and Treponema pallidum and associated factors among blood donors in Ethiopia: A retrospective study.

BackgroundBlood transfusion is a therapeutic procedure that has proven to be effective in saving millions of lives. However, its safety is still a crucial issue that needs due attention. Unsafe blood transfusion is one of the sources of transmission for infectious agents. Therefore, the objective of this study was to assess the sero-prevalence of Transfusion Transmittable Infections (TTIs) such as Human immunodeficiency virus (HIV), Hepatitis B Virus (HBV), Hepatitis C virus (HCV), Treponema pallidum, and associated factors among blood donors in Ethiopia.MethodsA retrospective cross-sectional study design was used to measure the prevalence of transfusion transmittable infections using data collected from 2014 to 2019 in fourteen blood bank facilities in Ethiopia. Screening of HIV, HBV and HCV was done by using the Enzyme-Linked Immunosorbent Assay (ELISA). Presence of Treponema pallidum infection was assessed using rapid plasma reagin (RPR). Records of blood donors were collected using a checklist from Central Blood Bank Laboratory (BBL) electronic database and reviewed. Data was entered, cleaned and analyzed using SPSS version 23. Logistic regression was fitted to identify factors associated with cumulative TTIs positivity, and for each of the transfusion transmittable infection. P value < 0.05 was considered statistically significant.ResultA total of 554,954 blood donors in the fourteen blood bank facilities from 2014–2019 was included in the study. The overall sero-prevalence of HBV, Treponema pallidum, HIV and HCV, was 2.4%, 0.9%, 0.4% and 0.4% respectively. The prevalence of TTIs was comparatively higher in 2014, 5.70% and lowest in 2019, 3.40%. The odds of screening HBV in blood donors in age group of 35–39 and 40–44 were 1.2 [1.1, 1.3] and 1.3 [1.1, 1.5] respectively. The odds of screening HCV in blood donors in the age group of 25–34, 35–44 and 45–54 were 1.3 [1.1, 1.5], 1.3 [1.1, 1.7] and 1.7 [1.2, 2.2] respectively. The likelihood of having at least one infection among blood donors was 1.2 [1.1, 1.3] times in male blood donors compared to female. The odds of getting at least one TTI and Treponema pallidum in unemployed blood donors were 2.4 [2.0, 2.8] and 8.1 [6.1, 10.7] respectively. The probability of getting those who have at least one TTIs, HBV and Treponema pallidum were higher in blood donors those who live in Semi Urban and Rural parts of the country than those who live in Urban areas. The odds of having at least one TTI, HBV and HCV in blood donors with mobile mode of blood donation were 1.4 [1.3, 1.6], 1.6 [1.4, 1.8], and 1.6 [1.1, 2.2].ConclusionThe current magnitudes of TTIs are lower when compared to other previous studies conducted in Ethiopia. Older age, male, occupation, donations from mobile sites, residents of semi urban and rural settings were found to be strongly associated with sero-positivity of TTIs. Hence, strict donor screening and testing particularly taking the above factors into consideration is strongly recommended.

Metaanálisis de la validez y el desempeño de las pruebas de tamización del virus de la hepatitis C en bancos de sangre, 2000-2018

Este estudio evaluó la validez y desempeño del inmunodiagnóstico del virus de la hepatitis C (VHC), con base en estudios publicados en la literatura científica mundial. Se diseñó y validó un protocolo de búsqueda y selección de investigaciones en las fases de la guía PRISMA, se analizaron los parámetros de sensibilidad, especificidad, cocientes de probabilidad, razón de odds y curva ROC, en MetaDisc. Se tamizaron 4602 estudios, de los cuales sólo 545 se realizaron en bancos de sangre y 18 evaluaron la validez diagnóstica de las pruebas para el VHC. La mayoría de los estudios fueron de Europa y Asia, con un 78 % basados en determinación de anticuerpos. Los estudios con detección de anticuerpos se realizaron en 21 483 donantes sanos y 3 145 infectados en quienes se halló una sensibilidad de 97,8 % (IC 95 % = 97,3 - 98,2), especificidad 99,0 % (IC 95 % = 98,9 - 99,2), cociente de probabilidad positivo 75,4 (IC 95 % = 27,2 - 209,2) y negativo de 0,02 (IC 95 % = 0,01 - 0,07) y área bajo la curva de 99,8 %. Se concluye que la detección de anticuerpos presenta excelente validez, desempeño y utilidad diagnóstica para la detección del VHC en donantes de sangre y población general.

Hepatitis B Versus Hepatitis C in Blood Donors

Introduction - Transmission of infectious diseases through donated blood is of concern to blood safety as transfusion forms an integral part of medical and surgical therapy. Blood transfusion carries the risk of transfusion-transmissible infections, including HIV, hepatitis, syphilis, malaria and infrequently toxoplasmosis. With every unit of blood, there is 1% chance of transfusion-associated problems including transfusion-transmitted diseases.Among all infections HIV and hepatitis are the most dreadful. Aims & Objectives - To find out the seroprevalence of hepatitis B virus and hepatitisC virus in blood donors , to determine the incidence of transfusion related disease in blood donors, to find the incidence of spectrum of diseases in blood bank donation, to find the age distribution of the cases studied and to find the sex distribution of the cases studied. Material & methods - The present study is being undertaken in the Department of Pathology MGM Medical College Indore. This is a retrospective study that will be conducted, during the period 2008 –2013. Tests are routinely done on every blood unit to exclude HIV, HBV, HCV, syphilis and malaria. Donors were selected by the standard criteria for donor fitness. The screening for HIV was done by ELISA using kits. HBS Ag was detected by ELISA. Anti-HCV test was done by ELISA. Results - In the present study, 94721 blood donors are observed in the year 2008-13 in the M. Y. Blood Bank.Majority of donors are voluntary donors 76.25 % as compared to replacement/relative donors 23.74 %.Out of total 94721 blood donations, majority of donors are male donors 94.9 % (89900) as compared to female donors 5.08 % (4821).The seroprevalence of HBV&HCV is 1.83% & 0.07% respectively.Seroprevalence is higher in the age group 26-35 year for HBV (0.93 %). HCV (0.025 %) is prevalent higher in age group 18-25 year. Over all Seroprevalence of transfusion transmitted disease in all donations in the year 2008-13 is 1.91 %. Seroprevalence of transfusion transmitted disease is higher in voluntary donors 1.44 % as compared to replacement/relative 0.532 % donors. Conclusion - voluntary blood donation should be encouraged for prevention of transfusion-transmissible diseases. The time and cost involved in screening donated blood can be reduced by an effective donor education and selection program that promotes self-exclusion by donors at risk of transfusion-transmissible infections. Introducing nucleic acid testing (NAT) for HBsAg and HCV is recommended to detect the infection during window period. DOI: 10.21276/AABS.2017.1306

Level of Human Antibodies Targeting HCV E1/E2 Peptides and Spontaneous Clearance of HCV in Blood Donors.

Hepatitis C virus (HCV) is a major health problem worldwide particularly in Egypt. The humoral immune response has an important function in the control of HCV infection. The aim of this study was to investigate the role of neutralizing antibodies in Hepatitis C Virus (HCV) clearance in infected individuals. This study was carried out on apparently healthy blood donors (n = 200). Detectable HCV antibodies were assessed by commercial ELISA and specific human immunoglobulins targeting peptides derived from HCV E1/E2 glycoproteins were measured in donors' blood using an in house optimized ELISA. Human IgG purification was carried out from positive HCV RNA and negative HCV RNA samples in order to evaluate its neutralizing activity in vitro using Huh 7 cells. The studied cohort included 96/200 subjects who tested positive for HCV antibodies, among which 56/96 (58%) samples were positive for HCV RNA (Group 1) and 40/96 (42%) samples had undetectable HCV RNA (Group 2). ELISA results showed that Human HCV immunoglobulin (HHI) targeting HCV E1 synthetic peptide (a.a. 315 - 323) was detectable in 63/96 (66%) and HHI targeting HCV E2 (a.a. 412 - 419) tested positive in 14/96 (15%) while 19/96 (20%) were positive for HCV E2 (a.a. 517 - 531). HHI higher than the cutoff level against peptide HCV E1 (a.a. 315 - 323) was detected in 22/63 (35%) in Group 2 and positive in 41/63 (65%) in Group 1. HHI against peptide HCV E2 (a.a. 412 - 419) was positive in 7 (50%) blood donors in Group 2 and also positive in 7 (50%) of Group 1. While HHI targeting HCV E2 (a.a. 517 - 531) was positive in 11 (60%) in Group 2 compared with 8 cases (40%) in Group 1. Purified human antibodies from cases positive for HCV antibodies and negative for HCV RNA showed in vitro neutralization at concentrations 30 and 10 µg/mL while the same concentration of purified human IgG from cases positive for HCV RNA showed no viral neutralization. The tested epitope(s) derived from HCV envelope E1 and E2 are important for viral clearance and hence can be used for HCV vaccine development.

Evaluation of the Procleix Ultrio Plus ID NAT assay for detection of HIV 1, HBV and HCV in blood donors.

Introduction:The Procleix Ultrio Plusassay is a new-generation qualitative in vitro nucleic acid amplification test used to screen for human immunodeficiency virus type 1 (HIV-1) RNA, hepatitis C virus (HCV) RNA and hepatitis B virus (HBV) DNA in blood donors. This study was performed to compare the Procleix Ultrio assay with the new-generation Procleix Ultrio Plus Nucleic Acid Test (NAT) assays.Materials and Methods:Ten thousand three hundred and two donor samples were run in parallel for ID NAT using the Procleix Ultrio and the Procleix Ultrio Plus assay. Simultaneously, enzyme-linked immunosorbent assay testing was performed on an EVOLIS Walk away System for HIV, HCV, HBsAg and anti-HBc. Reactive samples were confirmed using polymerase chain reaction.Results:In the 10,302 samples tested during the study period, we identified 15 NAT yields, and all these revealed HBV DNA in the discriminatory assays. Eight of these were exclusive yields from the Ultrio Plus assay and the remaining seven cases were determined as HBV NAT yield, both by the Procleix Ultrio as well as the Ultrio Plus assays, i.e. “Combined” yields. No HCV or HIV 1 yields were detected during the study period by either of two assays.Conclusion:With an overall yield rate of 1 in 687 and an exclusive yield rate of 1 in 1287, the Procleix Ultrio Plus assay proved to be highly sensitive in detecting occult HBV infections.

Hepatitis C Virus Antibodies in Patients with Hemoglobinopathies - Decreased Prevalence but Continued Transfusion-Related New Cases in Two New York City Hospitals

Purpose: There are no recent studies on hepatitis C virus (HCV) in patients with hemoglobinopathies who are also at risk for liver damage from iron overload after multiple blood transfusions. The aims of this study were to determine prevalence and incidence of HCV antibodies (anti-HCV) in patients with sickle cell diseases, and to assess how anti-HCV status impacts hospital attendance. Methods: Medical records of patients with sickle cell diseases who tested positive for anti-HCV and patients screened for anti-HCV after January 2009 in 2 New York City hospitals (Interfaith Medical Center and Kings County Hospital) were reviewed. Of 189 patients, there were 130 S/S, 36 S/C, 15 S/beta+ thalassemia, 6 S/beta0 thalassemia, 1 C/C and 1 A/A with 76% fetal hemoglobin. Transfusion history, drug use, liver function tests, HCV RNA status and hospital attendances on the year of the latest negative anti-HCV test and 2 years following the first documented positive anti-HCV test were recorded. Results: Anti-HCV was detected in 26/189 patients (13.8%). HCV RNA was detected in 10 of the 26 cases, negative in 7 cases and unknown in 9 cases. In 4 of the 26 anti-HCV positive patients, we were able to establish that anti-HCV had been non reactive before year 2000. HCV RNA was detected in one of these 4 patients, negative in the second and unknown in two cases. These four patients had no risk factors other than recent polytransfusion. None of the 23/189 patients who never received blood transfusion tested positive for anti-HCV. There was a significant difference in ALT (but not AST) between anti-HCV positive and anti-HCV negative patients (ALT 76.90± 155.80 IU/L and 59.06± 298.48 IU/L, respectively; Wilcoxon, p=0.01). The annual hospital attendance for anti-HCV positive patients was unchanged at 2 year follow-up, and there was no difference compared to anti-HCV negative patients (3.5 attendances for each group, p=0.78). Conclusion: The prevalence of anti-HCV in patients with hemoglobinopathies has decreased from 16.5% in 2002 to 13.8% presumably due to systematic screening of blood products (Richard S, Billett HH, 2002). New reactive anti-HCV cases with detectable HCV RNA occur in patients requiring a high number of transfusions and suggest that anti-HCV is not 100% sensitive in diagnosing HCV in blood donors and a more sensitive assay may be warranted. Although anti-HCV positive status does not appear to worsen the course of sickle cell disease, we suggest periodic testing and education of patients who test positive for anti-HCV on the importance of their assessment by a hepatologist.

Seroprevalence of HBV and HCV in blood donors: A study from regional blood transfusion services of Nepal

Background and Objective:Hepatitis B and hepatitis C are significant health problems that might involve the late sequel of liver cirrhosis and hepatocellular carcinoma. A high prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) in blood donors poses an increased risk of window period transmission through blood transfusion. The present study aimed to know the seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) among blood donors in regional blood transfusion services of Nepal.Materials and Methods:This was a retrospective study conducted among blood donors in Banke (5,211), Morang (5,351), and Kaski (5,995) blood transfusion services. Serum samples were tested for hepatitis B surface antigen (HBsAg) and anti-HCV antibodies using rapid enzyme immunoassays. The donors information was collected via the donor record register through their respective blood transfusion services. The software “Winpepi ver 3.8” was used for statistical analysis.Results:The seroprevalence rate of HBV was highest in the Banke (1.2%) followed by Biratnagar (0.87%) and Kaski (0.35%) (P < 0.0001). The seroprevalence of HCV was highest in the Morang (0.26%) followed by Kaski (0.16%) and Banke (0.11%) (P > 0.05). The seroprevalence of HBV was significantly higher than HCV in all three blood transfusion services. The burden of HBV as well as HCV seems to be higher in male donors (P > 0.05).Conclusion:The study revealed that the seroprevalence of HBV was alarmingly higher in two of the three blood transfusion services. Implementation of community-based preventive measures and improved strategies for safe blood supply might prove useful to decrease the seroprevalence.

Hepatitis C infection: recent insights relevant to transfusion safety

Hepatitis C virus (HCV) infects over 100 million persons worldwide, and is hence one of the most prevalent and clinically significant blood‐borne pathogens. The introduction of HCV antibody screening in the early 1990s led to detection of large numbers of infected donors and dramatic increases in blood safety. The seroprevalence of HCV in blood donors varies, ranging from rates as low as 0·01% in South Africa to ~0·5% in most developed countries, to &gt; 5% in focal endemic areas such as Egypt. Studies of HCV in infected donors and recipients were instrumental in the discovery of HCV, and have yielded ongoing insights into HCV epidemiology, natural history and pathogenesis. Recent examples include detailed characterization of the dynamics of acute HCV infection based on studies of plasma donor panels, and important contributions to understanding viral and host factors influencing HCV transmission and disease outcome based on linked donor‐recipient cohort studies. The addition of nucleic acid testing (NAT) for HCV RNA to routine HCV antibody screening of donors in 1999 further reduced the risk of transfusion‐transmitted HCV. Mini‐pool (MP)‐NAT screening has led to detection of well over 500 donors in the viraemic, preseroconversion phase of primary HCV infection, as well as to discrimination of seropositive donors into those with resolved and chronic infections. Studies of donors with acute, chronic/persistent and resolved HCV infections have further contributed to our understanding of viral and host genetic and immunological determinants of spontaneous clearance of HCV and short‐ and long‐term disease outcomes. This review will highlight these past scientific contributions, and present the results of a recent survey of the yield of HCV MP‐NAT screening and estimated residual risks of MP‐NAT screened transfusions in different regions of the world. Finally, the review will discuss available evidence for the infectivity of very low‐level viraemia that may be missed by MP‐NAT, information that is pivotal to modelling the residual risk of MP‐NAT screened blood transfusions, and which will guide further strategies to reduce risk by further enhancing screening or implementation of pathogen‐inactivation technologies.

Treatment of Recurrent Hepatitis C in Liver Transplant Recipients

The course of hepatitis C is accelerated after transplantation, with an average of 25% of patients developing cirrhosis within 5 years of transplantation. Consequently, the 5- and 10-year graft survival rates in hepatitis C virus (HCV)-infected patients are significantly lower than in HCV-uninfected patients. Therapeutic interventions to prevent HCV recurrence and/or alter the rate of disease progression after transplantation are desirable. Prophylactic therapy in the form of polyclonal HCV antibodies has not been effective at prevention of HCV re-infection, but one study suggests that higher-dose therapy may modify the severity of early disease recurrence. Pre-emptive antiviral therapy has modest efficacy and generally is poorly tolerated. Live donor liver transplant recipients and recipients with low model of end-stage liver disease scores pretransplantation may tolerate pre-emptive therapy best. The treatment of recurrent established disease with a combination of interferon and ribavirin has been the mainstay of management. Similar to pre-emptive therapy, tolerance is reduced and dose reductions are frequent. The sustained virologic response rates are less than 45% in studies to date. Histologic and biochemical improvements generally are more frequent than virologic responses. Overall, the treatment of HCV disease in transplant recipients leaves much to be desired and there is an urgent need of new HCV therapies in this patient population.

Serum Alanine Aminotransferase may not be a good surrogate marker of Hepatitis C Virus infection: A Study of Blood Donors in University of Maiduguri Teaching Hospital (UMTH), Maiduguri, Nigeria

Background: Prior to the identification of Hepatitis C virus (HCV) in 1989, raised serum alanine aminotransferase (ALT) was used as a surrogate marker for non-A, non-B (NANB) hepatitis agents to reduce the risk of post-transfusion hepatitis. Most of this NANB hepatitis was later found to be due to HCV infection. The absence of a national screening policy for HCV infection and the non-availability of screening facilities in most of our health institution may place many blood recipients at risk of HCV infection. Aim: This study was set to evaluate the usefulness of serum ALT as a surrogate marker of HCV infection in blood donors. Methodology: The study was conducted at the University of Maiduguri Teaching Hospital between August 2002 to November 2002. Ninety-six healthy, volunteer, blood donors were screened for anti-HCV using a third-generation ELISA test kits, and all had serum ALT levels measured. Result: Antibodies against HCV was detected in 10.4% of donors and the overall mean serum ALT level was 8.84 (±5.6) iu/L. The mean serum ALT level for anti-HCV positive and negative was 7.7 (±2.45) and 8.9 (±5.86) iu/L, respectively, of which, there was no statistically significant difference between the two groups. Conclusion: While the prevalence of antibodies against HCV in blood donors appears to be high in north-eastern Nigeria, serum ALT levels may not be a good surrogate marker for HCV infection in blood donors in this environment. Key Words: Blood donors, HCV, Serum ALT levels. Sahel Medical Journal Vol.7(3) 2004: 88-91

Seroprevalence of common transfusion-transmitted infections among blood donors in Bangladesh

Transfusion-transmitted infections (TTIs) remain a major global public health problem and a challenge to transfusion services worldwide particularly in developing countries in managing transfusion-dependent children especially the thalassaemics. However developed countries are not exempt from TTIs despite multiple layers of protection in their advanced blood collection centres. The magnitude of this problem is directly related to the prevalence of TTIs among blood donors. To assess the global burden of TTIs the World Health Organization (WHO) estimated that 3% of the world’s population (.170 million people) are infected with hepatitis C virus (HCV). The global prevalence of HCV reported by the WHO ranges from 10 to 15% to as little as 0.04%. HCV in blood donors varies from 0.4 to 19% including 0.9% among Namibian first-time blood donors. The overall prevalence of HCV in Bangladesh as documented in the WHO’s records ranges between 1 and 2.5% whereas it was observed in 2.4% of professional donors (poor people who sell their own blood to make a living and who have had no evident disease) in Bangladesh. However in voluntary donors (healthy adults who only donate blood in emergencies) in India the prevalence of HCV ranged from 0.8 to 1.78%. In Japan and Germany figures of 0.6% and 0.2–0.8% respectively have been reported. (excerpt)

The prevalence of hepatitis C virus (HCV) in infants and children after liver transplantation

Hepatitis C virus (HCV) is an important cause of liver injury following liver transplantation in adults. We hypothesized that the prevalence of HCV infection in children following liver transplantation would be lower than the prevalence in adults after liver transplantation because HCV-related liver disease leading to liver transplantation in children is low and children require less blood products than adults during transplantation. We therefore performed a cross-sectional study to determine the prevalence of HCV infection in children who had undergone liver transplantation. Serum samples were obtained from 62 of 65 (95.4%) consecutive patients surviving for more than six months after transplantation. Using a second-generation enzyme-linked, immunosorbent assay (ELISA-2) and a second-generation recombinant immunoblot assay (RIBA-II), antibodies to HCV were detected in 5.1% (3 of 59) of the subjects. Using a single-step, polymerase chain reaction (PCR), HCV RNA was detected in 6.2% (4 of 62). All HCV-positive children had undergone liver transplantation before the initiation of routine screening for HCV in blood donors; overall 30 patients were transplanted prior to routine screening of blood products for HCV. The prevalence of HCV in infants and children after liver transplantation in our study is substantially less than the rates reported in adults. This difference may be due, in part, to the lower volume of blood product exposure and to the fact that children, as opposed to adults, rarely have chronic HCV infection as a cause of end-stage liver disease.