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- Title
High rate of infectivity and liver disease in blood donors with antibodies to hepatitis C virus.
- Authors
Esteban, Juan Ignacio; Lopez-Talavera, Juan Carlos; Genesca, Juan; Madoz, Pedro; Viladomiu, Luis; Muniz, Eduardo; Martin-Vega, Camen; Rosell, Manuel; Allende, Helena; Vidal, Xavier; Gonzalez, Antonio; Hernandez, Jose Manuel; Esteban, Rafael; Guardia, Jaime; Esteban, J I; López-Talavera, J C; Genescà, J; Madoz, P; Viladomiu, L; Muñiz, E
- Abstract
<bold>Objective: </bold>To determine the epidemiologic, clinical, serologic, and histologic importance of antibodies to hepatitis C virus (anti-HCV) in blood donors.<bold>Design: </bold>Cross-sectional identification and prospective evaluation of seropositive donors; retrospective assessment of infectivity; and nested case-control study for risk factors.<bold>Setting: </bold>Liver unit of a referral-based university hospital.<bold>Subjects: </bold>Of 30,231 consecutive donors, 368 (1.2%) were found to be anti-HCV-reactive by enzyme-linked immunosorbent assay (ELISA). Two hundred and fifty-four of these 368 donors were evaluated for risk factors by comparison with 284 age- and sex-matched controls. Eighty-six spouses of seropositive donors were also evaluated.<bold>Measurements and Main Results: </bold>Twenty-four percent of the seropositive donors had a history of percutaneous exposure to blood. This rate increased to 45% when only those donors confirmed to be anti-HCV positive by a second-generation recombinant immunoblot assay (RIBA-2) were considered. A family history of liver disease (odds ratio, 2.8; 95% Cl, 1.6 to 4.8), previous blood transfusion (odds ratio, 6.1; 95% Cl, 3 to 12.5), and a history of tattooing or intravenous drug abuse (odds ratio, 8.4; 95% Cl, 2.3 to 31) were associated with anti-HCV seropositivity. An elevated alanine aminotransferase (ALT) level was found in 58% of the seropositive donors. Of the 150 donors tested, 104 (69%; Cl, 62% to 77%) were confirmed by RIBA-2 to be anti-HCV positive. Of the 105 donors who had a biopsy, 16% had normal histologic findings, 11% had minimal changes, 21% had chronic persistent hepatitis, 45% had chronic active hepatitis, and 7% had active cirrhosis. All 77 donors with RIBA-2-confirmed seropositivity had histologic abnormalities. Of 43 donors evaluated in an infectivity study, 82% were implicated in previous HCV transmission. Only 2.3% of the spouses were anti-HCV positive. The ELISA, RIBA-2, and ALT results correlated with infectivity and abnormal histologic findings.<bold>Conclusions: </bold>In our geographic area, almost 70% of donors who are anti-HCV positive by ELISA are confirmed to be positive by RIBA-2; most of these donors appear to be chronic carriers of HCV and have substantial liver disease.
- Subjects
SPAIN; HEPATITIS C virus; BLOOD donors; HEPATITIS C transmission; CARRIER state (Communicable diseases); COMPARATIVE studies; ENZYME-linked immunosorbent assay; EPIDEMIOLOGICAL research; HEPATITIS C; HEPATITIS viruses; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; RESEARCH; VIRAL antibodies; EVALUATION research
- Publication
Annals of Internal Medicine, 1991, Vol 115, Issue 6, p443
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/0003-4819-115-6-443