The major cause of transfusion viral hepatitis is?

NHM UP Staff Nurse - 2016

Applied Microbiology & Infection control

Easy

Appeared in: NHM UP Staff Nurse - 2016

Explanation

Hepatitis C virus (HCV) is the most common viral infection transmitted through blood transfusions.
Historically, before the implementation of routine, sensitive screening of blood products in 1992, HCV was the leading cause of post-transfusion hepatitis.
HCV has a high propensity (over 70%) to become a chronic infection, leading to long-term liver disease, cirrhosis, and hepatocellular carcinoma.
Even with advanced screening like Nucleic Acid Testing (NAT), a brief 'window period' exists where a newly infected donor might test negative but still be infectious, making HCV the most significant remaining risk.

Option A: Hepatitis A virus (HAV) is transmitted almost exclusively through the fecal-oral route, typically from consuming contaminated food or water.
Option B: While Hepatitis B virus (HBV) is blood-borne, its transmission via transfusion has been drastically reduced due to mandatory screening of all blood donors for Hepatitis B surface antigen (HBsAg) and the availability of an effective vaccine.
Option D: Hepatitis D virus (HDV), or Delta virus, is an incomplete virus that can only replicate in the presence of a Hepatitis B virus (HBV) infection. It cannot cause infection on its own.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Transfusion-Transmitted Infections (TTIs) as background academic context rather than a clinical decision trigger.
Nurses are at the forefront of transfusion safety. This includes the 'five rights' of transfusion: right patient, right blood product, right dose, right route, and right time, along with meticulous verification of donor unit screening.
Patient education is a key nursing responsibility. Patients receiving blood products should be informed to report any delayed symptoms such as fatigue, fever, dark urine, or jaundice, which could indicate a transfusion-transmitted infection.
What if? If a patient who received a blood transfusion 6 weeks ago reports persistent fatigue and yellowing of the eyes, the nurse must ensure prompt notification of the physician. The expected action is to draw blood for liver function tests and viral serology (HCV, HBV, HIV) and report the suspected transfusion reaction to the blood bank for a 'traceback' investigation.

How to Approach the Question

Analyze the question to identify the key concepts: 'major cause', 'transfusion', and 'viral hepatitis'.
Recall the different types of hepatitis viruses (A, B, C, D, E).
Systematically review the primary mode of transmission for each type. Eliminate Hepatitis A, as it is spread via the fecal-oral route, not typically by blood.
Consider the remaining blood-borne viruses: B, C, and D.
Rule out Hepatitis D as the 'major cause' because it is a dependent virus that requires a co-infection with Hepatitis B.
Differentiate between Hepatitis B and C. Both are transmitted by blood, but recall that routine screening for HBV (HBsAg) and vaccination have made it a less frequent cause of transfusion hepatitis than HCV. Historically and epidemiologically, HCV is known as the principal agent of post-transfusion hepatitis.

Concept Tested & Keywords

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