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Denmark, Sweden and Finland were trialling the Chiron/Ortho anti-HCV test, and several other countries were planning to do so.

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Dr Tuddenham wrote to John Canavan to support the move to evaluate the test based on detection of antibody to polypeptide synthesised by recombinant yeast clones of the HCV virus. This is because screening donor blood by such an assay could reduce the transmission rate of non-A non-B Hepatitis in single donor products and in some pooled plasma derivatives.

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Dr Lane wrote to Dr Rejman that the presence of antibody for Hepatitis C was not necessarily a marker of infectivity in HCV screening. However, Dr Gunson and the ACTTD were reporting the opposite of this, which Dr Mortimer and Professor Cash appeared to endorse.

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In a letter to Dr Rejman, Professor Arie Zuckerman stated that despite the projected costs of the screening test, the introduction of screening could not be delayed much beyond FDA approval considering the overall morbidity of chronic non-A non-B Hepatitis (including apparently autoimmune liver disease and hepatocellular carcinoma), and litigation which would be indefensible.

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A proposal for study of donations in three RTCs, Glasgow, Newcastle and North London, was agreed to be coordinated by Dr Gunson and the proposal stated that donors who tested anti-HCV positive were to be interviewed by a member of the medical staff to take medical history and arrange liver function tests.

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Dr Tedder prepared a preliminary report on the samples tested which showed how reactive the Abbott and Ortho testing were.

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The Advisory Committee on Virological Safety of Blood tabled a proposal on counselling of donors who tested anti-HCV positive and proposed to convene a meeting to consider and provide recommendations.

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An Advisory Committee on the Virological Safety of Blood discussed cases of post-transfusion hepatitis discovered through HCV screening, and second generation trials of HCV tests conducted with Ortho and Abbott.

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The first meeting of the ACTTD was held and its role was to brief the ACVSB about the decision on whether to introduce anti HCV screening.

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The ACTTD decided that Dr Gunson's paper should be used as the basis of the paper to be submitted to the department's committee and matters referred to ie counselling and flow charts would form part of the policy decisions to be taken if the Department of Health accepted the recommendation of the Committee.

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Dr Gunson reported the outcome of the ACVSB meeting stating that the Department of Health committee had deferred the decision to introduce routine screening and that it was hoped that by their next meeting at the end of April 1990 they would have received further advice and reached a decision.

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Dr P Mortimer in a letter to Dr Gunson stated that he still had several concerns about the operation of HCV screening and that it must be decided in the light of the performance of the best screening and confirmatory tests available, and these were to be considered at the next advisory committee meeting.

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At a meeting of the ACTTD it was agreed that confirmatory testing should be carried out using the RIBA-2 test. The committee debated the use of PCR tests but concluded that more information was needed.

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Professor Jean-Pierre Allain in a letter to Dr Gunson, Dr McClelland and all RTC directors in England and Wales proposed that they could take advantage of the two months before the implementation of HCV screening to carry out a study testing for anti-HCV in samples from recipients of blood transfusions.

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Dr Andrzej Rejman and John Canavan wrote to all members of the ACVSB enclosing a paper from Dr Philip Mortimer titled "Non-A, Non-B Hepatitis".

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In Dr Rejman's letter to the members of the ACVSB he stated that the Chiron test may also make surrogate testing obsolete, provided that the UKBTS and other studies confirmed the promising results so far reported, and assuming that the cost benefit analysis was satisfactory.

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At a meeting of the ACVSB Dr Gunson presented the preliminary report on the UKBTS study of surrogate and Chiron testing.

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In a letter to Professor Cash, Dr McIntyre stated that the ACVSB was considering the tests available and if it were thought to be desirable to introduce further routine screening, which would be done simultaneously throughout the UK.

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In a memo to Dr Jones, Dr Rejman stated that the ACVSB had decided that at present NANB was not to be routinely screened for.

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In a letter to Dr Jones, Dr Rejman stated that Dr Gunson had confirmed that there was a pilot study of Chiron testing of 10,000 samples in North London and would report the results at the next ACVSB meeting in October as well as the review of the European experience of Chiron testing which was due to be discussed in Rome mid September.

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