Correlates of hepatitis C virus (HCV) RNA negativity among HCV-seropositive blood donors

• Published in: Transfusion (Philadelphia, Pa.) Pa.), 2006-03, Vol.46 (3), p.469-475
• Main Authors: Busch, Michael P., Glynn, Simone A., Stramer, Susan L., Orland, Jennie, Murphy, Edward L., Wright, David J., Kleinman, Steven
• Format: Article
• Language: English
• Subjects: Adult; Aged; Alanine Transaminase - blood; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Banks; Blood Donors; Blood Transfusion; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Female; Hepacivirus; Hepatitis C - blood; Hepatitis C - epidemiology; Hepatitis C - prevention & control; Hepatitis C Antibodies - blood; Human viral diseases; Humans; Infectious diseases; Male; Medical sciences; Middle Aged; Miscellaneous; RNA, Viral - blood; Seroepidemiologic Studies; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Viral diseases; Viral hepatitis; Viremia - blood
• ISSN: 0041-1132; 1537-2995
• DOI: 10.1111/j.1537-2995.2006.00745.x

BACKGROUND:  Approximately 20 percent of persons infected with hepatitis C virus (HCV) clear viremia. Factors associated with resolution of viremia are not well defined. Implementation of routine nucleic acid testing (NAT) of blood donors has yielded a large data set for analysis of demographic correlates of resolved viremia. STUDY DESIGN AND METHODS:  HCV antibody and NAT data, liver enzyme (alanine aminotransferase [ALT]) results, and donor demographic characteristics were compiled for 2,579,290 allogeneic donations given at five large blood centers after NAT implementation in 1999 through December 2001. Donation HCV RNA status was compared between first‐time donors categorized by ALT levels, sex, age, race and/or ethnicity, country of birth, level of education, blood center location, and blood group, with chi‐square tests and multivariable logistic regression methods. RESULTS:  Of 35 confirmed‐seropositive repeat donors, 19 (54.3%) tested negative for the presence of HCV RNA; there was no association between RNA status and preseroconversion intervals (p = 0.74). Of 2105 RIBA‐positive, first‐time donors, 402 (19.1%) tested negative for the presence of HCV RNA by NAT (presumptive resolved infections). There were significant differences in the frequency of RNA negativity among first‐time donors categorized by ALT levels and by race and/or ethnicity. ALT levels were more likely to be elevated in RNA‐positive, first‐time donors (p