title: Clinical aspects and outcomes of volunteer blood donors testing positive for hepatitis-C virus infection in Taiwan: a prospective study.
abstract: OBJECTIVE
  The natural history of hepatitis-C virus (HCV) infection has been explored in volunteer blood donors, but not yet in hepatitis-B endemic areas. Whether previous or concurrent hepatitis-B virus (HBV) infection influences the natural history of HCV infection remains unknown. Thus, we followed the anti-HCV-positive blood donors who had past or concurrent HBV infection in Taiwan.
  
  
  METHODS
  From 1992 to 1993, 1588 anti-HCV reactive volunteer blood donors were referred to us from the Taipei Blood Center and 879 (55%) repeatedly reactive for anti-HCV were enrolled. Two hundred and forty-three donors (HCV RNA seropositive rate 49% by polymerase chain reaction (PCR)) received regular follow-ups (mean period: 4.9 years) with their liver disease status determined mainly by clinical and biochemical parameters, serum alpha-fetoprotein level and imaging studies. Hepatitis-C virus genotype and occult HBV infection were determined by PCR-based assays.
  
  
  RESULTS
  Of the initial 879 subjects, 250 (28%) had chronic hepatitis, nine (1%) had liver cirrhosis (LC) and two (0.2%) had hepatocellular carcinoma (HCC) already. In the 243 regularly followed donors, 30% had repeatedly normal serum alanine aminotransferase (ALT) and 70% had more than once elevated ALT. Cirrhosis developed in four (1.6%; follow-up period range: 2-6 years) and HCC in two (0.8%; follow-up period: 3 and 4 years, respectively). Distribution of HCV genotype and hepatitis-B surface antigen (HBsAg) did not differ between those with and those without elevation of ALT. Of the 15 donors with LC and/or HCC, only 1(7%) was positive for both HBsAg and HBV DNA and the other 14 were negative for both HBsAg and serum HBV DNA.
  
  
  CONCLUSIONS
  Incidentally detected hepatitis-C was progressive in a small proportion of anti-HCV-positive volunteer blood donors in Taiwan. Occult HBV infection played a minimal role in the development of LC in this donor population.
authors.affiliation: Department of Internal Medicine, National Taiwan University College of Medicine, National Taiwan University Hospital, 1 Chang-Te Street, Taipei 100, Taiwan.
authors.forename: Chun-Jen
authors.initials: CJ
authors.lastname: Liu
authors.forename: Pei-Jer
authors.initials: PJ
authors.lastname: Chen
authors.forename: Wen-Yi
authors.initials: WY
authors.lastname: Shau
authors.forename: Jia-Horng
authors.initials: JH
authors.lastname: Kao
authors.forename: Ming-Yang
authors.initials: MY
authors.lastname: Lai
authors.forename: Ding-Shinn
authors.initials: DS
authors.lastname: Chen
mesh_terms: D000328:Adult; D001782:Blood Donors; D006528:Carcinoma, Hepatocellular / Q000821:virology*; D015897:Comorbidity; D005260:Female; D016174:Hepacivirus / Q000235:genetics; D006509:Hepatitis B / Q000453:epidemiology* / Q000276:immunology; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D008103:Liver Cirrhosis / Q000821:virology*; D008113:Liver Neoplasms / Q000821:virology*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D013624:Taiwan / Q000453:epidemiology; D014838:Volunteers