COMMUNITY PREVALENCE OF HEPATITIS-C VIREMIA - A POLYMERASE CHAIN-REACTION STUDY

In order to estimate the prevalence of HCV carriage in an inner city h ealth district, we undertook a polymerase chain reaction (PCR) based s urvey of sera collected from 1,002 patients attending general practiti oners for reasons unrelated to liver disease. The series comprised 305 sample selected sera patients sample from sera 995 patients previousl y screened by C100 antigen-based anti-HCV tests. Overall, 7 patients w ere positive for HCV RNA. Four cases had anti-C100 antibodies to HCV, 2 were strictly negative but had high-normal/borderline optical densit ies ELISA assay, while one was completely anti-HCV negative. All but o ne had normal liver function tests. Only 3/7 PCR positive cases had an y serum marker for hepatitis B (HBV) exposure (2 HBsAg positive, 1 IgM anti-HBc positive). The minimum point prevalence of HCV carriage in t his community is 0.7%, approximating the HBsAg carriage in the same po pulation (1%). HCV carriage in this inner city population is considera bly higher than would be predicted by blood donor surveys. A positive anti-HCV antibody (anti-C100) test is poorly predictive (similar to 10 %) of HCV RNA carriage in a general practice based population in which measurement of ''surrogate'' (HBV related) HCV markers would have det ected only 3/7 cases of presumed chronic HCV carriage. (C) 1994 Wiley- Liss, inc.