Donor-derived hepatitis C in the era of increasing intravenous drug use: A report of the Disease Transmission Advisory Committee.

Journal Article (Journal Article)

The opioid epidemic has resulted in a potential increase in donors in the testing window period for hepatitis C virus (HCV). We analyzed HCV reports to the Disease Transmission Advisory Committee (DTAC) between 2008 and 2016 to estimate the risk of HCV transmission. In 15 of 95 (16%) reports, at least one recipient developed proven/probable donor-derived HCV resulting in 32 infected recipients. Seven transmissions occurred during the nucleic acid testing (NAT) window period; four occurred during serological window period. The other four transmission occurred due to human error (3) and false-negative serology (1). All seronegative-exposed liver and lung recipients contracted HCV; 18/21 (86%) kidney and 3/4 (75%) heart recipients developed HCV. Four transmitting donors died of intravenous drug overdose, three in 2016 and one in 2012. Among donors with a history of intravenous drug use (IVDU), drug intoxication as a mechanism of death, or increased risk status, and negative screening HCV testing, the risk of transmission to a recipient was about 1 in 1000. The overall risk of transmitting HCV from NAT-negative donors with IVDU is low and consistent with modeling data. This information may be helpful to clinicians counseling potential recipients offered these organs.

Full Text

Duke Authors

Cited Authors

  • Kaul, DR; Tlusty, SM; Michaels, MG; Limaye, AP; Wolfe, CR

Published Date

  • October 2018

Published In

Volume / Issue

  • 32 / 10

Start / End Page

  • e13370 -

PubMed ID

  • 30080289

Electronic International Standard Serial Number (EISSN)

  • 1399-0012

Digital Object Identifier (DOI)

  • 10.1111/ctr.13370


  • eng

Conference Location

  • Denmark