GENOTYPIC VARIATION, CLINICAL AND HISTOLOGICAL CHARACTERISTICS OF CHRONIC HEPATITIS-C DETECTED AT BLOOD-DONOR SCREENING

Since blood donor screening for the hepatitis C virus (HCV) began in 1 991 a large number of seropositive subjects have been detected and sev eral reports have suggested a high prevelance of liver disease, The ai m of this study was to evaluate the severity of liver disease in HCV-p ositive blood donors in terms of the clinical, biochemical and histolo gical abnormalities and to investigate the relationships between these features and the mode of transmission, duration of infection and vira l genotype. We evaluated 54 consecutive blood donors who were positive for HCV both on serological testing and polymerase chain reaction. Tw enty-three (43%) had a history of intravenous drug abuse and 17 (31%) had received blood transfusions. In only two (4%) was no risk factor i dentified. The mean duration of infection in those with a clear histor y of HCV exposure was 12 years, Eighty-three percent were HCV genotype s 1 or 3. All had abnormal liver biopsies with chronic hepatitis and s everal patients had periportal or portal-portal fibrous septa, but the re was none with architectural distortion or cirrhosis. There was no c orrelation between severity of liver disease and duration of HCV infec tion, mode of transmission or viral genotype. In the majority of HCV c arriers detected at donor screening there is a chronic hepatitis with bridging necrosis in one third, but the degree of fibrosis is minimal and cirrhosis was not present in our patients. The long period of infe ction of many patients suggests that irreversible liver injury does no t necessarily develop at an early stage despite persistent infection.