title: Donor levels of serum alanine aminotransferase activity and antibody to hepatitis B core antigen associated with recipient hepatitis C and non-B, non-C outcomes.
abstract: BACKGROUND
  Hepatitis virus(es) that are neither hepatitis B (HBV) nor hepatitis C (HCV) (non-B, non-C [NBNC]) may be transmitted by transfusion. The present study assessed donor values for alanine aminotransferase (ALT) and antibody to hepatitis B core antigen (anti-HBc) for their association with HCV and NBNC hepatitis outcomes among allogeneic blood recipients.
  
  
  METHODS
  Data on blood donors and recipients enrolled in the Transfusion- Transmitted Viruses Study in four United States cities from 1974 through 1980 were supplemented by anti-HBc testing of donors and anti-HCV evaluation of recipients. Two statistical approaches estimated the value of these indirect tests in detecting donors associated with HCV seroconversion and NBNC hepatitis in recipients.
  
  
  RESULTS
  For HCV cases, donor ALT alone (at > or = 60 IU/L) had a sensitivity and a specificity of 30 and 96 percent, respectively, and anti-HBc alone (at > or = 60% inhibition) had a sensitivity and specificity of 53 and 86 percent, respectively. The two markers combined had a sensitivity and a specificity of 69 and 83 percent. For NBNC hepatitis cases, each measure had low sensitivity (20%) that was not improved by using both (28%) [corrected].
  
  
  CONCLUSIONS
  The indirect tests proved to be equal in sensitivity to the first-generation anti-HCV tests. The positive predictive power of these indirect tests in the 1980s was sufficient to affect HCV incidence in studies during that period. Improved anti-HCV assays, however, replaced the need for indirect tests. The sensitivity of indirect tests for NBNC hepatitis contributed little.
authors.affiliation: University of Southern California, Los Angeles, USA.
authors.forename: J W
authors.initials: JW
authors.lastname: Mosley
authors.forename: W
authors.initials: W
authors.lastname: Huang
authors.forename: D O
authors.initials: DO
authors.lastname: Stram
authors.forename: M J
authors.initials: MJ
authors.lastname: Nowicki
authors.forename: F B
authors.initials: FB
authors.lastname: Hollinger
authors.forename: R D
authors.initials: RD
authors.lastname: Aach
authors.forename: C E
authors.initials: CE
authors.lastname: Stevens
authors.forename: L H
authors.initials: LH
authors.lastname: Barbosa
authors.forename: G J
authors.initials: GJ
authors.lastname: Nemo
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D001782:Blood Donors; D006509:Hepatitis B / Q000635:transmission*; D006512:Hepatitis B Core Antigens / Q000097:blood; D006526:Hepatitis C / Q000453:epidemiology / Q000635:transmission*; D006801:Humans; D015999:Multivariate Analysis; D065227:Transfusion Reaction
chemical_list: D006512:Hepatitis B Core Antigens; D000410:Alanine Transaminase