LACK OF EVIDENCE FOR A ROLE OF HCV IN HEPATITIS-ASSOCIATED APLASTIC-ANEMIA

Hepatitis-associated aplastic anaemia (HAAA) is usually related to non -A, non-B hepatitis agents but the prevalence of anti-hepatitis C viru s (HCV) antibodies is similar in HAAA and aplasia of other origins acc ording to the results of the ELISA1 assay. This fact could reflect eit her that HCV is not involved in HAAA or that HAAA-associated defective immune function could yield false negative assays despite on-going HC V infection. To test these hypotheses, we compared 19 patients with HA AA, including three ELISA1-positive, to 23 patients with aplasia of kn own and unknown origin, including eight ELISA1-positive, who were matc hed for age, sex and blood transfusion units. HCV infection was search ed for by the second-generation recombinant-immunoblot assay (RIBA2), and by the polymerase chain reaction which detects HCV viraemia. HCV v iraemia was detected in four among the 19 patients with HAAA and in si x among the 23 patients with aplasia of other causes. HCV does not cle arly appear responsible for hepatitis-associated aplastic anaemia whic h could be due to non-A, non-B, non-C hepatitis virus. HCV viraemia is frequent in severe aplastic anaemia, even without detectable anti-HCV antibodies, and reflects mainly transfusion-associated HCV infection.