Detection of hepatitis C viral sequences in blood donations by "nested" polymerase chain reaction and prediction of infectivity.

Of 1100 blood donations tested during a prospective study of post-transfusion non-A, non-B hepatitis (NANBH), 6 (0.55%) were repeatedly reactive in a commercial assay for antibodies to the C100 protein of hepatitis C virus. Only 1 of the 6 donations (17%) transmitted NANBH to a recipient. Hepatitis C virus RNA sequences were detected in the serum of the transmitting donor by an assay which used the polymerase chain reaction (PCR) and non-radioisotopic detection. No such sequences were detected in the other 5 donors positive for anti-C100. Stored serum samples from blood donors who had been involved in three episodes of post-transfusion NANBH in 1981 also contained hepatitis C viral sequences. Although the PCR assay in its present form is not suitable for mass donor screening, the presence of hepatitis C viral sequences detected by PCR in blood donations seems a better predictor of infectivity than the presence of anti-C100 alone.