Epidemiology, serological markers, and hepatic disease of anti-HCV ELISA-2-positive blood donors

• Published in: Digestive diseases and sciences 1996-10, Vol.41 (10), p.1933-1938
• Main Authors: SALMERON, F. J, PALACIOS, A, PEREZ-RUIZ, M, TORRES, C, OYONARTE, S, FERNANDEZ-MONTOYA, A, RUIZ-EXTREMERA, A
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Alanine Transaminase - blood; Biological and medical sciences; Blood Donors; Clinical Enzyme Tests; Enzyme-Linked Immunosorbent Assay; Female; Hepacivirus - isolation & purification; Hepatitis C - diagnosis; Hepatitis C - epidemiology; Hepatitis C - pathology; Hepatitis C - transmission; Hepatitis C Antibodies - analysis; Human viral diseases; Humans; Immunoblotting; Infectious diseases; Liver - pathology; Male; Medical sciences; Middle Aged; Risk Factors; RNA, Viral - analysis; Seroepidemiologic Studies; Spain - epidemiology; Viral diseases; Viral hepatitis
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/bf02093592

The epidemiology associated with hepatitis C virus (HCV) infection, serologic reactivity, and hepatic disease related to anti-HCV-positive donors of Granada were researched. From 1990 through 1993, medical and epidemiological information and anti-HCV and HCV RNA testing were evaluated in 46,741 blood donors. Serum samples were obtained for anti-HCV ELISA and RIBA and HCV RNA determination. A liver biopsy was conducted in all anti-HCV positives by confirmatory second-generation RIBA to analyze the hepatic lesion and the presence of HCV RNA. The anti-HCV prevalence was 1.12%. A total of 228 anti-HCV second-generation ELISA positive blood donors were analyzed. Intrafamiliar transmission rate was 1.7%. Transfusion and intravenous drug abuse (IVDA) antecedents were associated with a higher risk of seroconversion. A RIBA-positive result was related to high second- and third-generation ELISA ratios (90%), HCV RNA positivity (89%), and elevated alanine aminotransferase (ALT) levels (88%). Approximately 50% of donors with normal ALT levels had high ELISA ratios and second-generation RIBA and HCV RNA positive results. Of the second-generation RIBA indeterminate results, 42% and 82% of the c22 and 33% and 100% of the c100 reactivities were third-generation RIBA and HCV RNA positive, respectively. Liver biopsy was conducted in 85 donors, 74% of whom had a chronic hepatitis and 83% had detectable HCV RNA levels. Chronic hepatitis was diagnosed in 88% vs 43% of donors with elevated and normal alanine aminotransferase levels, respectively. ELISA and confirmatory HCV RNA determinations should be routinely employed in donor screening. A liver biopsy should be conducted in patients with elevated ALT levels and normal ALT levels when viremic.