Discovery of Hepatitis C
randomized, double blind controlled trial of the efficacy of immune serum
globulin for the prevention of post-transfusion hepatitis. A
Seeff LB, Zimmerman HJ, Wright EC, Finkelstein JD, Garcia-Pont P, Greenlee
HB, Dietz AA, Leevy CM, Tamburro CH, Schiff ER, Schimmel EM, Zemel R, Zimmon DS, McCollum RW
A double blind, randomized, controlled trial has been conducted in 11 Veterans Administration hospitals during a 49-month period to compare the relative efficacies of immune serum globulin (ISG) and an albumin placebo
for the prevention of post-transfusion hepatitis (PTH). A total of 2204 patients, of whom 1094 received ISG, participated in the study. The results
indicate that ISG significantly reduced the incidence of icteric type non-B hepatitis only (inferred to be also type non-A hepatitis). Adverse reactions
were rare, and the ISG did not significantly alter the incubation period or duration of the disease.
The data suggest, however, that a similar reduction
in type non-A, non-B hepatitis would have occurred had commercial blood been excluded from use. Analysis of the 241 patients who developed hepatitis
indicates that type B hepatitis constituted less than 20% of the cases each year of the study. Furthermore, the efficacy of the
ISG, manufactured in 1944, against apparent type non-A, non-B hepatitis suggests that this
overlooked disease has existed from at least that time. Host- and transfusion-related factors that might have modified the development of PTH
were examined. The use of commercial blood was observed to be the most important risk factor.
It is concluded that the PTH incidence can be most effectively reduced by eliminating commercial donor blood, and continuing to screen volunteer
donors for hepatitis B surface antigen (HBsAg) by sensitive procedures. Of prime importance is the need to define the agent(s) responsible for type
non-A, non-B hepatitis.
Randomized controlled trial
See 1942 Seeff- Yellow Fever Vaccine