Can the blood-transmitted hepatitis problem be solved?

Of the approaches presently available for prevention of blood-transmitted hepatitis, most clearly effective is the avoidance of high-risk donor populations, such as most paid commercial donors. It should be emphasized that even after screening for hepatitis B antigen most paid donor blood carries with it a five-ten times higher risk of transmitting hepatitis than volunteer donor blood. Hepatitis B screening is certainly the next most useful approach. However, it has been pointed out that even with the most sensitive of current assays, as much as two-thirds of infective blood may not be eliminated. In part this is due to failure to detect hepatitis B antige, which may be detectable by such currently investigational approaches as selective antibody inhibition or testing for Core antibody. However, a major factor is the inability of hepatitis B screening to eliminate all infectious blood appears to be due to the existence of viruses other than hepatitis B that play a major role in blood-transmitted hepatitis. Tests for detection of carriers of this virus, or viruses, remain to be developed. Improved reporting of hepatitis cases with investigation and registration of implicated donors may provide an additional means for reducing the incidence of hepatitis transmission. The efficiency of additonal approaches, such as transaminase screening of donors and passive or active immunization, remains to be determined.