LIVER-DISEASE IN ANTI-HEPATITIS-C VIRUS-POSITIVE NORWEGIAN BLOOD-DONORS

In a prospective study of 16,756 consecutive blood donors, we found 54 donors (0.3%) to be antihepatitis C virus (HCV)-positive by a first-g eneration enzyme-linked immunosorbent assay. After retesting, 18 donor s were confirmed positive or indeterminate by a second-generation reco mbinant immunoblot assay. Sixteen of these donors were found positive by a second-generation enzyme-linked immunosorbent assay, and 15 of th ese were positive by HCV polymerase chain reaction with two primer set s. Nine donors (50%) had a history of drug abuse. In 15 donors found p ositive by a second-generation enzyme-linked immunoblot assay liver bi opsy specimens were taken after at least 6 months' follow-up. In all e xcept one hepatitis C RNA-negative donor, histologic abnormalities wer e observed, even when alanine aminotransferase (ALAT) levels were cont inuously normal or only moderately elevated. The abnormalities were le ss pronounced in these donors (n = 5) than in donors with ALAT levels increased more than twice the upper normal limit (p < 0.05). In conclu sion, we found the proportion of previous drug abusers in anti-HCV-pos itive blood donors to be high. We confirm that the presence of anti-HC V (second generation) usually, and HCV-RNA always, seems to indicate o ngoing infection-also when ALAT levels are normal. Our study further s uggests that low-activity hepatitis, evaluated by ALAT levels, may ind icate a milder disease.