HEPATITIS-C VIRUS-INFECTION IN SPANISH VOLUNTEER BLOOD-DONORS - HCV RNA ANALYSIS AND LIVER-DISEASE

Objective: To evaluate in a large group of volunteer blood donors the prevalence of antibodies to hepatitis C virus (anti-HCV) and the relat ion of transaminase (ALT) levels and viraemia to liver damage. Design: A prospective study. Setting: Transfusion Centre of the Autonomous Co mmunity of Madrid and the Liver Unit of the Princesa University Hospit al. Patients: From a population of 55 587 volunteer blood donors, 160 seropositive cases were further evaluated for virological and histolog ical assessment. Methods: Anti-HCV was tested by ELISA-2 and RIBA-2 as says. HCV RNA was analysed by nested PCR. Liver biopsies were obtained in 35 volunteer blood donors with abnormal ALT levels. Results: The p revalence of anti-HCV detected by ELISA-2 was 0.93%. Serum ALT was abn ormal in 61 of the 160 volunteers (38.1%). Of these, RIBA-2 was positi ve in 96.7% and HCV RNA was detectable in 96.1%. Serum ALT was normal in the remaining 99, 70.7% being RIBA-2 negative and 98.3% HCV RNA neg ative. The majority of biopsies (85.6%) showed chronic hepatitis. Conc lusion: This study demonstrates that in blood donors screening for ant i-HCV, a positive ELISA-2 test, when associated with abnormal ALT leve ls, is effective in recognizing subjects with active infection detecte d by HCV RNA and liver disease. Concerning ELISA-2 positive volunteer blood donors with normal ALT, long-term studies are warranted to eluci date whether they are really infected by HCV.