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Dr John Barbara gave oral evidence in the Hepatitis C litigation about the medical profession's perception of Hepatitis C and HIV in the early 1990s, as well as the sensitivity of tests for HCV and HIV going to the root of the problem of pre-transfusions.

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Marcela Contreras and John Barbara wrote to Dr Harvey Alter, stating it was unethical to delay anti-HCV screening pending the US study of post-transfusion hepatitis infections, and questioned the causal association between transfusion and cases of cirrhosis.

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Dr Marcela Contreras, director of North London Blood Transfusion Centre, wrote to Dr Gunson regarding funding for the introduction of anti-HCV screening of blood donations in 1990 and admitted that she did not consider anti-HCV testing to be a top priority.

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At a meeting of the North London Blood Transfusion Centre, discussions included results of the US studies, significance of positive anti-HCV test results, equipment and kits, and options to have positive/borderline samples sent for further testing.

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Dr Lane sent Dr Rejman a paper for discussion at the next ACVSB meeting which concluded that the procedures to minimise hepatitis virus transmissions continued to present problems, giving rise to a need to address the requirements for a marker to identify non-A non-B Hepatitis (HCV) carrier status.

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Professor Cash wrote to Dr Gunson, stating it was important for the SNBTS to look at the prevalence of the Chiron test positives in the donor community, noting 5000 donations were to be selected from those with ALT data already identified.

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Dr Lloyd, NBTS, wrote to Mr Garland, director of management services of the Northern Regional Health Authority in relation to non-A non-B Hepatitis, noting the fairly rapid mounting pressure for the test to be introduced in the UK, likely without funding by the Department.

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Marcela Contreras wrote to Dr Gunson in relation to factors to consider before placing orders for routine donor screening with the new anti-HCV test, including whether "lookback" would be required, the expense of obtaining and processing confirmatory samples and the data from the preliminary studies in Europe requiring extension.

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Professor Cash wrote to Dr Gunson in relation to the Chiron Test, stating their Service would not move unilaterally unless instructed to do so by SHHD, and he noted that SNBTS would only be able to discuss contracts for supply (of the HCV test) when instructed to do so.

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Professor Cash wrote to colleagues by way of update, indicating NANB (Chiron) Testing soon.

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Professor Cash wrote to Dr Archie McIntyre re NANB (Chiron) testing, noting his anticipation that a decision whether to introduce such testing throughout UKBTS would be made in October 1989.

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Peter Savage advised Dr Gunson that FDA licensure of the ORTHO HCV antibody ELISA test was expected early first quarter of 1990.

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Dr Gunson wrote to Mr Graham Hart (Department of Health) regarding anti-HCV testing of blood donations, providing information regarding anti-HCV tests available from the Chiron Corporation, and provided estimate costings of pilot trials in RTCs.

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Dr Mitchell reported back to the ACTTD that "The Chiron test is now being used in a large number of Blood Transfusion Laboratories throughout the World and one is struck by the rapidity of this introduction."

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Dr Metters wrote a memo to Mr Hart, discussing ACVSB concerns regarding the Chiron test, Ortho offering free tests and Dr Gunson's views that Chiron would eventually be introduced.

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A draft protocol of a pilot study to assess the introduction of routine anti-HCV tests in RTCs was completed, with the aims to conduct anti-HCV tests on circa 5000 donations in 1989, evaluate the performance of the test and assess the costs of screening other than the costs of test kits.

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NBTS met to discuss provisional results obtained from the evaluation of the Ortho HCV kit at three blood transfusion centres, including surrogate testing, other studies, screening implications, replacement of donations that tested positive, confirmatory test protocol, supply of equipment from Ortho, and the cost of testing.

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Dr Boulton wrote to Dr Lloyd stating that Dr Lloyd's decision to start HCV-testing earlier than the other RTCs was "breaking ranks" and "not conducive to the image of a co-ordinated Service".

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Dr Elwyn Elias of the Queen Elizabeth Hospital wrote to Dr Rejman, Department of Health, regarding the introduction of Hepatitis C testing of all blood donors in the UK.

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Miss Keenay wrote a note to Dr Metters and the Parliamentary Secretary about testing for non-A non-B Hepatitis in donated blood, namely that there was insufficient data regarding the Ortho test to advise its routine introduction.

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