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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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The ACVSB felt that there was no case for using surrogate tests for Non-A Non-B Hepatitis.

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A report for a multi-centre study on Non-A Non-B Hepatitis surrogate screening was completed.

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Dr Kernoff wrote to Dr Colvin describing Non-A Non-B Hepatitis as "a serious disease with long-term consequences".

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Alter et al published a paper titled 'The Chronic Sequelae of Non-A Non-B Hepatitis B' in the Annals of Internal Medicine journal.

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A study by Ware et al titled 'Etiology of liver disease in renal transplant patients' reported that infection with NANBH accounted for much of serious, often fatal, complications of renal transplantation.

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In his written statement, Professor John Gillon noted that there was no doubt that screening with one or both of the the ALT or anti-HBc screening tests would have prevented some cases of NANBH, and in spite of the lack of data on the incidence of PTNANBH this would have been a desirable outcome.

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In a written submission to the Inquiry, SNBTS stated that they have on balance reached the conclusion that surrogate testing for NANBH should have been introduced.

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Alter et al wrote in the New England Journal of Medicine that 'surrogate assays for anti-HBc and alanine aminotransferase would have detected approximately half the anti-HCV-positive donors involved in the transmission of hepatitis they had identified.

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A study from Canada, published in the Lancet, found that 70 percent of hepatitis C infections would have been avoided by the use of the two surrogate markers, ALT and anti HBc.

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Journal article titled 'The Chronic Sequelae of Non-A Non-B Hepatitis B' described chronic NANBH as symptomatically mild and unaccompanied by physical signs or laboratory evidence of autoimmune disease or severe chronic liver disease..

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