HEPATITIS-C VIRUS-RNA IN BLOOD UNITS WITH ANTIBODIES DETECTABLE BY A 2ND-GENERATION PASSIVE HEMAGGLUTINATION ASSAY, ANTIBODIES TO SYNTHETICCORE PEPTIDES OR ELEVATED TRANSAMINASE LEVELS

Blood units from 3383 donors were tested for antibodies to hepatitis C virus (HCV) by a second-generation passive hemagglutination assay (PH A-2) with detector cells coated with three recombinant HCV proteins. T hey were tested also for antibodies to synthetic HCV core peptides (an ti-CP9 and anti-CP10) by enzyme immunoassays and for alanine aminotran sferase (ALT). PHA-2 was reactive in 32 (0.9%) units, high-titered ant i-CP9 and/or anti-CP10 was detected in 101 (3.0%), and elevated ALT le vels (>45IU/L) in 99 (2.9%). At least one of these markers were detect ed in 209 units (6.2%), and HCV RNA was tested for in 197 of them. HCV RNA was detected in 21 units including 19 initially reactive on PHA-2 of which 17 were repeatedly reactive, 19 with anti-CP9 and/or anti-CP 10 in high titers, and 5 with elevated ALT levels. Two units were reac tive only on PHA-2, while the other two had anti-CP9/anti-CP10 as the sole indicator of hepatitis C viremia. These results indicated that PH A-2 and anti-CP9/anti-CP10 would be complementary in detecting blood u nits with HCV RNA, and effective in further decreasing the risk of pos t-transfusion hepatitis C.