title: Anti-hepatitis C virus (HCV) screening at a Canadian Red Cross center: significance of a positive c100 HCV enzyme-linked immunosorbent assay.
abstract: The c100 hepatitis C virus (HCV) enzyme-linked immunosorbent assay (ELISA) has been used to screen blood donors to prevent transfusion-associated non-A,non-B hepatitis. This test is not specific, and only about 25 percent of c100 HCV ELISA-positive blood samples appear to transmit hepatitis C. However, the intensity of the ELISA (sample/cutoff ratio [S/C], greater than 2) could identify a subpopulation of donors that are at high risk for transmitting hepatitis. Blood samples from 20,186 volunteer blood donors at a Canadian Red Cross blood transfusion center were screened for antibodies to HCV using the c100 HCV ELISA. Fifty-nine (0.3%) of these donors were repeatably reactive on ELISA. When their samples were tested with the c100 recombinant immunoblot assay (RIBA) and second-generation RIBA (RIBA-2), 26 (44%) and 31 (52%) samples, respectively, were found to be positive. Thirty-three of the 59 ELISA-reactive donors had an S/C greater than 2. Of these 33 donors, 30 (91%) had elevated alanine aminotransferase (ALT), 27 (82%) were RIBA-2 positive, and 22 (67%) had risk factors for hepatitis. In contrast, of the 26 ELISA-reactive donors with S/C less than 2, only 7 (27%) had elevated ALT, and 4 (15%) were RIBA-2 positive and also had high risk factors for hepatitis. Thus, while the HCV ELISA may lack specificity, its intensity can serve to identify a subgroup of donors that are at high risk for transmitting hepatitis.
authors.affiliation: Canadian Red Cross Blood Transfusion Service, Ottawa, Ontario.
authors.forename: A
authors.initials: A
authors.lastname: Giulivi
authors.forename: M T
authors.initials: MT
authors.lastname: Aye
authors.forename: E
authors.initials: E
authors.lastname: Gray
authors.forename: V
authors.initials: V
authors.lastname: Scalia
authors.forename: P
authors.initials: P
authors.lastname: Gill
authors.forename: G
authors.initials: G
authors.lastname: Cheng
mesh_terms: D000328:Adult; D001782:Blood Donors; D002170:Canada; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D005260:Female; D006508:Hepatitis Antibodies / Q000097:blood*; D018937:Hepatitis C Antibodies; D006801:Humans; D008297:Male; D008403:Mass Screening; D012011:Red Cross
chemical_list: D006508:Hepatitis Antibodies; D018937:Hepatitis C Antibodies