Alanine aminotransferase, gamma-glutamyltransferase, antibodies to hepatitis B core antigen and antibodies to hepatitis C virus in blood donor screening. A prospective study in Finland.
Alanine aminotransferase (ALT), gamma-glutamyl-transferase and hepatitis B core antibodies were evaluated as donor markers in a prospective study of 685 open-heart surgery patients. Of these three surrogate markers, only an ALT level greater than or equal to 2 SD above the log mean had a significant association with recipient non-A, non-B hepatitis (NANBH, p = 0.02). Antibodies to the hepatitis C virus (anti-HCV) were detected by an enzyme immunoassay in 7 of the 136 units transfused to the 11 NANBH patients and 29 of 3,650 not associated with hepatitis (p less than 0.001). Calculated from this subgroup of donors, the anti-HCV test would have a 15.6% positive predictive value with 0.92% donor loss and thus is superior as a primary screening marker to all the three surrogate tests. The predictive value could be substantially increased by subsequent ALT testing or by the use of a recombinant immunoblot anti-HCV assay.
Finnish Red Cross Blood Transfusion Service, Helsinki.
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Ebeling
D000410:Alanine Transaminase / Q000032:analysis; D001782:Blood Donors; D001803:Blood Transfusion / Q000592:standards*; D005387:Finland; D016174:Hepacivirus / Q000276:immunology*; D006508:Hepatitis Antibodies / Q000032:analysis*; D006510:Hepatitis B Antibodies / Q000032:analysis*; D006512:Hepatitis B Core Antigens / Q000276:immunology*; D006526:Hepatitis C / Q000635:transmission; D006801:Humans; D011446:Prospective Studies; D005723:gamma-Glutamyltransferase / Q000032:analysis
D006508:Hepatitis Antibodies; D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D005723:gamma-Glutamyltransferase; D000410:Alanine Transaminase