Penrose 27 87 The Lancet in July 1981 

When non-A non-B hepatitis was first recognised, many British workers seemed to regard it as a purely American problem. Lately, non-A non-B hepatitis has been accepted in the U.K. as a serious hazard of treatment with factor VIII and factor IX concentrates, but no-one has paid much attention to this type of hepatitis in the patient who receives a few units of blood or platelets. In a UK prospective study of post-transfusion hepatitis,[124] frank hepatitis developed in 1%, there were sustained increases of alanine aminotransaminase (ALT) in 4.5%, and the ALT was raised at some time after transfusion in 20%. Although only a small proportion of these cases of hepatitis and "transaminitis" seemed to be due to hepatitis B virus, nothing has been done to assess the value of preventive methods other than hepatitis B screening.

American workers have been less complacent.

Penrose Inquiry 27.113 

Dr Edward Follett and Dr Brian Dow,[164] reporting on a study of NANB Hepatitis in the West of Scotland in 1984, wrote: Evidence from USA would suggest that if ALT/SGPT testing is performed on all blood donations and those with high levels excluded, around 29-40% of non-A, non-B PTH cases could be prevented with the loss of around 3% of blood donations.

Penrose Inquiry 27.117 

After an outbreak of post-transfusion NANB Hepatitis following the use of certain BPL immunoglobulin concentrates,[168] Professor Andrew Lever, Professor Howard Thomas[169] and others contrasted the lack of tests for the NANB Hepatitis virus(es) with tests for other viruses, at the end of 1984:

Sensitive radioimmunoassays for hepatitis B surface antigen and IgM anti-HB-core allow identification of cases of post-transfusion hepatitis caused by the hepatitis B virus, and similar assays exist for the diagnosis of hepatitis A, cytomegalovirus, and Epstein-Barr virus infections which are rarer causes. Most post-transfusion hepatitis, however, is caused by a group of unidentified viruses designated non-A, non-B

Penrose Inquiry 27.132 

Again, the SNBTS Directors were aware of developments in the USA. In a letter to Dr Fraser on 28 August 1986 on the question of surrogate testing, Professor Cash stated, 'I have a feeling that as the drums are beating louder and louder in other parts of the world on this topic the Brits remain fast asleep'.[194] While he noted that the suggestion of a UK prospective trial had been raised at the recent NBTS meeting and 'went down like the proverbial lead balloon',

Penrose Inquiry 27.156 

On 26 January 1987, Dr Forrester produced a note, 'Material for PMO Report'. He made the following comments on blood transfusion and NANB Hepatitis: This "hepatitis" is a residual rag-bag when Hepatitis B and Hepatitis A are excluded, and consequently no specific test can detect it. It is relatively benign. But U.S. blood banks have noted that the combination of a liver function test and a test for the core (not the surface) antigen of Hepatitis B distinguishes perhaps a third of blood donations which would convey [NANB Hepatitis] and allows them to be excluded.