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SSHD informed DHSS that the Biomedical Research Committee had decided not to support the ALT and anti-HBc screening of blood donation multi-centre study and the applicants were not allowed to resubmit.

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A paper titled 'Post-Transfusion Non-A, Non-B Hepatitis: Significance of Raised ALT and Anti-HBc in Blood Donors' concluded that, at the time, a surrogate screening programme was not justified but further studies were required.

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An article titled 'Incidence and Significance of Hepatitis B Core Antibody in a Health Blood Donor Population' was published. It was concluded that although surrogate testing introduction may eventually be unavoidable, only a controlled prospective study would provide the necessary information to determine the significance of donor anti-HBc levels in relation to PTH, especially NANB, in the United Kingdom.

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At a SNBTS Director's Co-ordinating Group meeting it was agreed that the financial year 1988/89 should be spent in experimentation and evaluation of high ALT levels but that positive donors should not be deferred.

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At a SBTS Directors' meeting it was agreed not to introduce Non-A Non-B Hepatitis surrogate screening in Scotland until it had become UK policy.

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At a SNBTS Directors' meeting it was stated that it was believed that the Birmingham RTC was about to begin routine testing of ALT and anti-HBc.

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At a meeting of SNBTS and Haemophilia directors, Dr Forrester said that a decision on the introduction of Non-A Non-B Hepatitis screening would wait until the outcome of the multi-centre study. Dr McClelland and Professor Cash "considered the delay unjustifiable."

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It was agreed that a questionnaire on the use of Non-A Non-B Hepatitis surrogate screening in different countries would be circulated prior to the next European Health Committee meeting.

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Dr Gunson shared the replies to the questionnaire on the use of surrogate screening for Non-A Non-B Hepatitis in different countries with the Advisory Committee on the Virological Safety of Blood.

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At a meeting of the Steering Committee on Multi-Centre Study of ALT and anti-HBc Screening of Blood Donations, the study protocol was discussed in detail and it was anticipated that screening would begin on 1 September 1988.

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At a meeting of Regional Transfusion Directors it was noted that the results of the ALT multi-centre study were not expected before late spring 1989.

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At meeting of SNBTS directors, Dr Gunson explained that Chiron had agreed to test 1,000 randomly selected samples from the multi-centre study. The Scottish transfusion directors confirmed they would not start surrogate testing unless and until it was supported by the Department of Health and SHHD,

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At the first meeting of the ACTTD it was agreed that no recommendation to introduce ALT testing would be made until the multi-centre study was completed. It was noted that surrogate screening might be introduced in response to the position taken in other countries in relation to plasma products.

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Dr Gunson explained to the NBTS/CBLA Liaison Committee the NBTS's view that the introduction of ALT testing was unnecessary. It was agreed that the issue
would be considered further at another meeting

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At the first ACVSB meeting a paper on surrogate testing for NANBH was considered, although a final decision would have to await the results of further research.

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A paper provided to ACVSB members explained it was too early to report on the UKBTS study into surrogate testing and conclusions would not be drawn until the result of the Chiron tests were known.

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It was agreed at the meeting of the Advisory Committee on the Virological Safety of Blood that the use of Chiron or surrogate testing for HCV would be influenced by Chiron data once released.

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Dr Gunson recommended that the routine introduction of non-specific tests for HCV should be deferred unless necessary to acquire product licences.

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The Advisory Committee on Transfusion Transmitted Diseases agreed that Dr Gunson's report, both Chiron's test (now called the anti-HCV test) and NANBH surrogate screening, should be used as the basis for a paper to be submitted to the ACVSB.

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Dr Gunson presented a summary of results of the study on Alanine Amino-Transferase and Hepatitis B Core Screening of Blood Donations for an ACVSB meeting.

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