Antibody to hepatitis C virus and liver disease in volunteer blood donors.
OBJECTIVE
To evaluate the specificity of antibodies to hepatitis C virus (anti-HCV) and their relation to liver disease in blood donors.


METHODS
Case series of consecutive blood donors found positive for anti-HCV by enzyme-linked immunosorbent assay (ELISA). Patients were evaluated for antibody specificity using a recombinant immunoblotting assay (RIBA) and were evaluated for biochemical evidence of liver disease. Patients showing increased alanine aminotransferase (ALT) levels had a liver biopsy.


METHODS
University hospital.


METHODS
Fifty consecutive blood donors found to be anti-HCV positive on both an initial and repeat ELISA. Inclusion criteria were as follows: an absence of hepatitis B surface antigens and non-organ-specific autoantibodies; a daily alcohol intake of less than 50 g; no history of recent hepatotoxic drug use; and normal serum levels of alpha 1 antitrypsin, ceruloplasmin, and copper.


RESULTS
Anti-HCV positivity was confirmed by RIBA in only 13 of 50 donors (26%) who had positive ELISA results. These 13 donors had an elevated ALT level and histologic evidence of chronic hepatitis, which was active in 8 patients (62%) and had already produced cirrhosis in 2 patients (15%). In contrast, the 17 donors with an intermediate RIBA pattern had only mild and often nonspecific histologic liver abnormalities. The 20 patients with a negative RIBA result had normal ALT levels.


CONCLUSIONS
In blood donors, the anti-HCV RIBA is not only more specific than the anti-HCV ELISA, but is also useful in identifying patients who have an underlying chronic liver disease.
Alberti
A
A
Clinica Medica II, Padova, Italy.
Chemello
L
L
Cavalletto
D
D
Tagger
A
A
Dal Canton
A
A
Bizzaro
N
N
Tagariello
G
G
Ruol
A
A
D001706:Biopsy; D001782:Blood Donors; D002908:Chronic Disease; D004797:Enzyme-Linked Immunosorbent Assay; D016174:Hepacivirus / Q000276:immunology*; D006508:Hepatitis Antibodies / Q000032:analysis*; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D015151:Immunoblotting; D008107:Liver Diseases / Q000453:epidemiology* / Q000276:immunology / Q000473:pathology
D006508:Hepatitis Antibodies