Is donating plasma still risky for contracting HCV?


bag press

Example of a modern plasma device

I first read about viral infections due to past unsanitary practices in plasmapheresis centers in the Pepin’s book, The Origin of Aids.  

In this 1999 follow-up report about an HCV outbreak in Austria (then called non-A, non-B hepatitis), the cause was believed due to contaminated plastic bags.  They identified the common location, but not the way(s) in which NANB spread inside the centers from donor-to-donor.

In 1977/78 an epidemic outbreak of non-A, non-B hepatitis occurred in a plasmapheresis centre in Salzburg, Austria, involving 30 donors. Epidemiological data suggested spread within the centre. The mode of transmission remained speculative but was believed to be due to contaminated plastic bags used for reinfusing erythrocytes.

However these centers and the industry continued to be suspected/implicated as late as 2001 in the spread of HCV.  In a  letter to the Editor in The Lancet, Mexican medical professionals write:

Sir—Since the 1970s, outbreaks of blood-borne diseases in plasmapheresis centres have been described. These
outbreaks probably arose because of practices associated with human blood injection, reuse of material, and sharing
of syringes or intravenous lines during apheresis. These procedures have made commercial plasmapheresis centres a
high-risk environment for transmission and could explain the high rates of seroconversion for blood-borne diseases reported among paid donors.

Patricia Volkow, M.D. (et. al) inform Lancet’s readers that the main problem is not the donors’ characteristics alone but the centers and/or the plasma broker business.

The high prevalence of different markers for blood-borne diseases in end products of plasma recorded since 1973 cannot be explained by inclusion of high-risk donors.

The authors report that in less-developed countries, plasma is “trafficked through station countries” relabeled and re-exported.  The letter specifically names the problem of HCV in blood products and compares the situation with that experienced with HIV’s spread.

And this is far after the critical years in the early 90’s when testing for HCV became possible.   Volkow has little faith in the veracity of the country-of-origin labels.  I assume that Volkow also did not have much  faith in viral inactivation in 2001 either.  In a 2005 HIV study  Volkow provides a long list of resources about these centers. It appears clear that a history of  being a paid donor should be recognized as a risk factor for HIV (or HCV)–not just being a blood product recipient.  The CDC was not completely silent on these problems, but almost.

A modern device that seals tubing

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