Hepatitis c and transfusion a lookback primer

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4/2/2017 Hepatitis C and transfusion: A 'lookback' primer

®

Author

Joy L Fridey, MD

Section Editor Arthur J Silvergleid, MD

Deputy Editor Jennifer S Tirnauer, MD

Hepatitis C and transfusion: A 'lookback' primer

INTRODUCTION

In 2000, primary care physicians, surgeons, and other medical specialists began receiving notification from

hospital blood banks that a patient they had previously treated or were currently treating may have been

exposed to hepatitis C virus (HCV) as a result of blood transfusion This United States Public Health Service (USPHS)-mandated notification, developed in conjunction with the Food and Drug Administration (FDA),

came as a surprise to practitioners, who were faced with the task of locating patients, informing them about

the possible exposure, providing appropriate testing and counseling, and possibly evaluating or treating

those who were found to be HCV positive, in a process referred to as "lookback."

Lookback encompasses the activities associated with tracing and notifying patients who may have received

blood or blood components infected with transfusion-transmissible pathogens (TTP) from a previously

infectious disease test-negative, but now positive, donor Lookback is required for other TTPs such as HIV,

but hepatitis C was unique because of the United States federal government's highly prescriptive

requirements for patient notification, which involved community physicians who cared for or were caring for

these patients

Recognizing that involvement in an HCV lookback process is an infrequent and possibly new experience for

many practitioners, the purpose of this discussion is to review the rationale for HCV lookback, define

lookback, outline regulatory expectations, and provide physicians with resources that can make the patient

notification process less onerous

This topic discusses the rationale for the HCV lookback and the role of the physician in locating affected

patients, with a focus on those in the United States Similar programs exist in other countries

Recommendations for screening and diagnosis of HCV infection in the general population is presented

separately (See "Screening for chronic hepatitis C virus infection".)

GOVERNMENT RESPONSE TO THE HCV EPIDEMIC AND THE HISTORY OF HCV LOOKBACK

It is estimated that up to four million Americans are infected with HCV [1] The majority of these individuals

have been exposed to the virus through the sharing of needles used in injection drug use, and a smaller

percentage through sexual contact, perinatally, or occupationally Approximately one-third of infected people

do not identifiably fall into these risk categories, but have a history of behavior, such as multiple sex

partners, that places them at higher risk [2,3] (See "Epidemiology and transmission of hepatitis C virus

infection".)

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References

Top

Literature review current through: Jan 2017 | This topic last updated: thg 6 17, 2013

The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment.

Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or

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