Liver disease in anti-hepatitis C virus-positive Norwegian blood donors.
In a prospective study of 16,756 consecutive blood donors, we found 54 donors (0.3%) to be anti-hepatitis C virus (HCV)-positive by a first-generation enzyme-linked immunosorbent assay. After retesting, 18 donors were confirmed positive or indeterminate by a second-generation recombinant immunoblot assay. Sixteen of these donors were found positive by a second-generation enzyme-linked immunosorbent assay, and 15 of these were positive by HCV polymerase chain reaction with two primer sets. Nine donors (50%) had a history of drug abuse. In 15 donors found positive by a second-generation enzyme-linked immunoblot assay liver biopsy specimens were taken after at least 6 months' follow-up. In all except one hepatitis C RNA-negative donor, histologic abnormalities were observed, even when alanine aminotransferase (ALAT) levels were continuously normal or only moderately elevated. The abnormalities were less pronounced in these donors (n = 5) than in donors with ALAT levels increased more than twice the upper normal limit (p < 0.05). In conclusion, we found the proportion of previous drug abusers in anti-HCV-positive blood donors to be high. We confirm that the presence of anti-HCV (second generation) usually, and HCV-RNA always, seems to indicate ongoing infection--also when ALAT levels are normal. Our study further suggests that low-activity hepatitis, evaluated by ALAT levels, may indicate a milder disease.
Nordøy
I
I
Medical Dept. A, National Hospital, Oslo, Norway.
Schrumpf
E
E
Elgjo
K
K
Flesland
O
O
Andersen Glende
J
J
Orjasaeter
H
H
Siebke
J C
JC
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001483:Base Sequence; D001782:Blood Donors; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016174:Hepacivirus / Q000276:immunology* / Q000302:isolation & purification; D006508:Hepatitis Antibodies / Q000032:analysis*; D006526:Hepatitis C / Q000453:epidemiology; D006521:Hepatitis, Chronic / Q000453:epidemiology; D006801:Humans; D015151:Immunoblotting; D008107:Liver Diseases / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009664:Norway / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis; D019966:Substance-Related Disorders
D006508:Hepatitis Antibodies; D012367:RNA, Viral; D000410:Alanine Transaminase