Incidence of non-A, non-B hepatitis after screening blood donors for antibodies to hepatitis C virus and surrogate markers.
OBJECTIVE
To compare the effect of screening blood donors for antibodies to hepatitis C virus (anti-HCV) on the incidence of non-A, non-B hepatitis in recipients with that of screening blood donors for antibodies to hepatitis B core antigen (anti-HBc) and elevated alanine aminotransferase levels.


METHODS
Cohort analysis of serum samples from donors and recipients. Recipients were followed for 12 months to determine the occurrence of non-A, non-B hepatitis.


METHODS
The blood-transmitted viruses unit and the liver unit of a university teaching hospital.


METHODS
A total of 250 patients who had open heart surgery and their 3142 blood donors.


METHODS
Donor sera were tested for anti-HCV by enzyme-linked immunosorbent assay (ELISA) and, in the event of a positive result, by recombinant immunoblot assay (RIBA). Antibodies to anti-HBc and serum alanine aminotransferase (ALT) levels were also measured. Measurements of anti-HCV and ALT activity in recipients were done before transfusion and at regular intervals during follow-up.


RESULTS
Of the 250 transfusion recipients, 40 developed non-A, non-B hepatitis. Of the 3142 donors, 70 were positive for anti-HCV by ELISA, 440 were positive for anti-HBc, and 177 had alanine aminotransferase levels between 0.67 and 1.33 mukat/L. The sensitivity (87%), specificity (89%), positive predictive value (59%), and negative predictive value (97%) of blood-donor screening were higher for anti-HCV than for anti-HBc (82%, 36%, 21%, and 91%, respectively) and 70%, 29%, and 91%, respectively). The expected number of donors excluded because of the presence of anti-HCV was considerably smaller than that of donors with positive results for surrogate markers of hepatitis.


CONCLUSIONS
Screening blood donors for the presence of anti-HCV is more accurate than screening for surrogate markers (anti-HBc and ALT) and protects more effectively against post-transfusion non-A, non-B hepatitis.
Barrera
J M
JM
Hospital Clinic i Provincial, University of Barcelona, Spain.
Bruguera
M
M
Ercilla
M G
MG
Sánchez-Tapias
J M
JM
Gil
M P
MP
Costa
J
J
Gelabert
A
A
Rodés
J
J
Castillo
R
R
D000410:Alanine Transaminase / Q000097:blood; D000956:Antigens, Viral; D001782:Blood Donors; D004797:Enzyme-Linked Immunosorbent Assay; D006508:Hepatitis Antibodies / Q000097:blood*; D006510:Hepatitis B Antibodies / Q000097:blood; D006526:Hepatitis C / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D015151:Immunoblotting / Q000379:methods; D015994:Incidence; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000276:immunology; D012680:Sensitivity and Specificity; D065227:Transfusion Reaction; D017361:Viral Nonstructural Proteins; D014764:Viral Proteins / Q000276:immunology
D000956:Antigens, Viral; C064544:C100 protein, hepatitis C virus; D006508:Hepatitis Antibodies; D006510:Hepatitis B Antibodies; D011994:Recombinant Proteins; D017361:Viral Nonstructural Proteins; D014764:Viral Proteins; D000410:Alanine Transaminase