Diversity and origin of hepatitis C virus infection among unpaid blood donors in the Netherlands

Thijs J. W. van de Laar, Marco H. G. M. Koppelman, Akke K. van der Bij, Hans L. Zaaijer, H. Theo M. Cuijpers, Cees L. van der Poel, Roel A. Coutinho, Sylvia M. Bruisten

Research output: Contribution to journalArticleAcademicpeer-review

26 Citations (Scopus)

Abstract

BACKGROUND: To improve transfusion policy and to increase understanding of the spread of hepatitis C virus (HCV) in the general population, HCV infections among voluntary Dutch blood donors were examined with molecular epidemiologic techniques. STUDY DESIGN AND METHODS: During 6 years, 1997 through 2002, confirmed anti-HCV-positive donors were interviewed on HCV-associated risk behavior with a standardized questionnaire. Additionally, HCV isolates were genotyped, partially sequenced, and compared to sequences obtained from Dutch injecting drug users (IDUs). RESULTS: HCV prevalence and incidence rates among Dutch donors were extremely low; the residual risk of transmitting HCV was calculated to be 1 in 30 million donations. Former IDUs (21%), transfusion recipients (30%), and immigrants (>12%) were identified as major HCV risk groups. Cryptogenic transmission caused 18 percent of infections among new donors and all infections among repeat donors. Compared to IDUs, genotype distribution among donors was highly diverse; major subtypes were 3a (27%), 1a (24%), 1b (24%), 2a/b (10%), and 4 (9%). Half of the donors were infected with IDU-related subtypes 1a and 3a, whereas subtype 1b mainly spread via blood transfusion and various other nosocomial modes of transmission in the past. HCV infections acquired in endemic countries could be clearly identified based on genotype. CONCLUSION: Different modes of transmission are linked to infections with certain HCV subtypes, suggesting separate HCV epidemics, but spillover between different risk groups underlines the value of molecular epidemiologic techniques to gain insight into the origin and dynamics of HCV infections on a population level
Original languageEnglish
Pages (from-to)1719-1728
JournalTransfusion
Volume46
Issue number10
DOIs
Publication statusPublished - 2006

Cite this