SIGNIFICANCE OF THE PRESENCE OF ANTIBODIES AGAINST HEPATITIS-C VIRUS IN ASYMPTOMATIC BLOOD-DONORS

In order to determine the significance of anti-hepatitis C virus (anti -HCV) antibodies in blood donors, 46 consecutive asymptomatic individu als were recruited at the blood bank of Hospital Sao Paulo, Sao Paulo, Brazil. They were submitted to an interview to collect epidemiologica l data and to clinical examination and blood samples were obtained for biochemical, serological and virological analysis. All patients were followed for a minimum period of six months and those with abnormal me an alanine aminotransferase (ALT) levels were submitted to a liver bio psy after giving informed consent. Hepatitis C virus RNA (HCVRNA) was detected by the polymerase chain reaction (PCR) in 22/46 (47.8%) patie nts and this finding was associated with parenteral risk factors (P = 0.03) and ethanol abuse (P = 0.03). HCVRNA positivity was also associa ted with abnormal levels of ALT (P<0.001) and gamma-glutamyl transpept idase (gamma-GT) (P = 0.01). Abnormal ALT levels were a good marker of viremia, with 86.4% sensitivity and 79.2% specificity. Twenty-three p atients with elevated mean ALT levels were submitted to a liver biopsy and histopathological changes were observed in 17 of them (73.9%). HC VRNA positivity was associated with severe forms of hepatic disease (c hronic hepatitis and cirrhosis). These results indicate the need for a judicious evaluation of all anti-HCV-positive blood donors, including clinical examination, biochemical tests and liver histology when ALT is persistently elevated.