[12] This was the missing piece that revealed that NANBH had severe, and sometimes fatal, consequences. Throughout the 1980s, I continued to prospectively follow blood recipients, track hepatitis incidence and investigate donor screening interventions that might reduce risk. By 1980, TAH incidence had fallen to about 6% as the consequence of lessened blood use in cardiovascular surgery. In trying to further reduce risk, we did a retrospective analysis that predicted that the introduction of ALT testing of blood donors might reduce TAH incidence by 30%,[13] as did a similar study by Aach et al.[14] Hence, in 1981, we began

routine ALT testing of donors, but despite predictions, this did not have a measurable effect on hepatitis outcomes. Epacadostat in vivo A similar retrospective analysis predicted that hepatitis B core antibody (anti-HBc) testing of donors could serve as a surrogate for NANBH virus carriers and reduce TAH by 30%-40%.[15] This confirmed results from a multicenter, prospective study (Transfusion-Transmitted Virus) sponsored by the National Heart, Lung and Blood Institute.[16] this website I

am proud of the fact that, in 1986, I presented data at the annual meeting of the American Association of Blood Banks, and then separately to each of the major blood organizations, in which I urged the introduction of routine anti-HBc donor screening. Such testing was introduced nationally in 1987 and not only prevented some cases of NANBH, but also detected occult hepatitis B carriers and served as a surrogate for human immunodeficiency virus carriers. Our ongoing prospective studies showed that subsequent to anti-HBc testing, TAH incidence fell to about 4% by 1989. This was quite gratifying, but we continued to be frustrated by our inability to find the NANB agent, despite extensive efforts. Together with Dr. Purcell’s lab,

we utilized highly pedigreed infectious sera and attempted every serologic approach known at the selleck inhibitor time. In addition, Steve Feinstone was experimenting with subtractive hybridization in these very early days of emergent molecular biology. This frustration spilled out in a poem that I wrote in 1988, which I titled, “I Can’t See the Forest for the HBsAgs”: I think that I shall never see This virus called non-A, non-B A virus I cannot deliver And yet I know it’s in the liver A virus that we often blame, But which exists alone by name No antigen or DNA No little test to mark its way. A virus which in our confusion Has forced us into mass collusion To make exist just by exclusion But is it real or an illusion? Oh GREAT LIVER in the sky, Show us where and tell us why Send us thoughts that will inspire us Let us see this elusive virus If we don’t publish soon, They’re going to fire us! I think it was this poem that pushed the field forward, because in 1988, I received a call from George Kuo suggesting that Chiron had cloned the NANB agent and developed an Ab assay.