VOLUNTEER BLOOD-DONORS WITH ANTIBODY TO HEPATITIS-C VIRUS - CLINICAL,BIOCHEMICAL, VIROLOGICAL, AND HISTOLOGIC FEATURES

Objective: To assess the clinical significance of antibody to hepatiti s C virus (anti-HCV) in volunteer blood donors. Design: Prospective co hort study. Setting: National Institutes of Health Clinical Center, a tertiary referral research hospital. Patients: 60 anti-HCV-positive bl ood donors, divided into three groups of 20 persons each: Group I had normal alanine aminotransferase levels, group II had levels elevated t o values less than twice the normal range, and group HI had levels ele vated to values greater than twice the normal range. Measurements: Med ical history, results of laboratory and virologic testing, and percuta neous liver biopsy findings. Results: Participants with normal alanine aminotransferase levels were older and more often female than those w ith abnormal levels. The source of infection, duration of disease, sym ptom score, and amount of alcohol consumed were similar in the three g roups. Hepatitis C virus RNA was detectable in 85% of participants, mo re commonly in the groups with elevated alanine aminotransferase level s (95%) than in the group with normal levels (65%); however, titers we re similar in all groups. Examination of liver biopsy specimens showed chronic hepatitis in 54 participants (90%) and cirrhosis in 1 partici pant. The only normal liver biopsy specimens (n = 3) were those from p articipants who were HCV RNA negative and had normal alanine aminotran sferase levels. Conclusions: Most blood donors with anti-HCV have chro nic hepatitis C regardless of their serum alanine aminotransferase lev els. Donors with normal alanine aminotransferase levels and no HCV RNA in their serum generally have normal liver histologic findings or min imal changes and have probably recovered from HCV infection.