Epidemiology, serological markers, and hepatic disease of anti-HCV ELISA-2-positive blood donors.
The epidemiology associated with hepatitis C virus (HCV) infection, serologic reactivity, and hepatic disease related to anti-HCV-positive donors of Granada were researched. From 1990 through 1993, medical and epidemiological information and anti-HCV and HCV RNA testing were evaluated in 46,741 blood donors. Serum samples were obtained for anti-HCV ELISA and RIBA and HCV RNA determination. A liver biopsy was conducted in all anti-HCV positives by confirmatory second-generation RIBA to analyze the hepatic lesion and the presence of HCV RNA. The anti-HCV prevalence was 1.12%. A total of 228 anti-HCV second-generation ELISA positive blood donors were analyzed. Intrafamiliar transmission rate was 1.7%. Transfusion and intravenous drug abuse (IVDA) antecedents were associated with a higher risk of seroconversion. A RIBA-positive result was related to high second- and third-generation ELISA ratios (90%), HCV RNA positivity (89%), and elevated alanine aminotransferase (ALT) levels (88%). Approximately 50% of donors with normal ALT levels had high ELISA ratios and second-generation RIBA and HCV RNA positive results. Of the second-generation RIBA indeterminate results, 42% and 82% of the c22 and 33% and 100% of the c100 reactivities were third-generation RIBA and HCV RNA positive, respectively. Liver biopsy was conducted in 85 donors, 74% of whom had a chronic hepatitis and 83% had detectable HCV RNA levels. Chronic hepatitis was diagnosed in 88% vs 43% of donors with elevated and normal alanine aminotransferase levels, respectively. ELISA and confirmatory HCV RNA determinations should be routinely employed in donor screening. A liver biopsy should be conducted in patients with elevated ALT levels and normal ALT levels when viremic.
University Hospital, Granada, Spain.
F J
FJ
Salmerón
A
A
Palacios
M
M
Pérez-Ruiz
C
C
Torres
S
S
Oyonarte
A
A
Fernández-Montoya
A
A
Ruiz-Extremera
D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001782:Blood Donors; D004796:Clinical Enzyme Tests; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016174:Hepacivirus / Q000302:isolation & purification; D006526:Hepatitis C / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000635:transmission; D018937:Hepatitis C Antibodies / Q000032:analysis*; D006801:Humans; D015151:Immunoblotting; D008099:Liver / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D013030:Spain / Q000453:epidemiology
D018937:Hepatitis C Antibodies; D012367:RNA, Viral; D000410:Alanine Transaminase