Hepatitis C virus infection rate in volunteer blood donors from the Western Cape--comparison of screening tests and PCR.
BACKGROUND
Hepatitis C virus (HCV) antibody seroprevalence studies overestimate the true infection rate. No data exist on the incidence of HCV or its clinical features in blood donors of sub-Saharan Africa.


OBJECTIVE
To establish the true incidence of HCV infection in volunteer blood donors in the Western Cape, and compare risk factors and clinical and biochemical features of viraemic and non-viraemic subjects.


METHODS
All donors attending the Western Province Blood Transfusion Service between December 1992 and August 1994 were screened prospectively for anti-HCV using the Abbott second-generation assay. Positive donors were evaluated clinically and biochemically. Their sera were examined for HCV-RNA by the polymerase chain reaction (PCR).


RESULTS
Of 66314 donors screened, 275 (0.41%) were anti-HCV-positive. Of these 13.6% were PCR-positive (0.056% of all donors). PCR-positive patients had more risk factors for HCV acquisition (P < 0.01), symptoms of hepatitis (P = 0.02) and clinical signs of liver disease (P = 0.05) and higher alanine (P < 0.0001) and aspartate aminotransferase levels (P < 0.0001) than PCR-negative donors. However, clinical and biochemical features did not discriminate adequately between PCR-positive and negative donors. Liver biopsies performed in 9 of 13 PCR-positive cases showed mild inflammation, but no cirrhosis.
Tucker
T J
TJ
Department of Medicine, University of Cape Town.
Voigt
M
M
Bird
A
A
Robson
S
S
Gibbs
B
B
Kannemeyer
J
J
Galloway
M
M
Kirsch
R E
RE
Smuts
H
H
D001782:Blood Donors; D004797:Enzyme-Linked Immunosorbent Assay; D006526:Hepatitis C / Q000097:blood / Q000453:epidemiology*; D018937:Hepatitis C Antibodies / Q000097:blood*; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D013019:South Africa / Q000453:epidemiology; D014766:Viremia / Q000453:epidemiology*
D018937:Hepatitis C Antibodies; D012367:RNA, Viral