HEPATITIS-C IN SICKLE-CELL-ANEMIA

We evaluated the contribution of hepatitis C virus infection to liver disease in patients with sickle cell anemia. Antibody to hepatitis C v irus (anti-HCV) by commercial enzyme immunoassay and a second confirma tory assay were assayed in 121 consecutive patients with sickle cell a nemia. Anti-HCV was detected in 25 of 121 patients (20.7%). Of patient s transfused > 1 0 units of blood products, 30.3% were anti-HCV seropo sitive, whereas 8.6% of those patients who transfused < 10 units were seropositive. In 11 of the 121 patients, serum alanine aminotransferas e levels were repeatedly elevated. Nine of these 11 patients were anti -HCV seropositive, one was positive for hepatitis B surface antigen, a nd one was negative for all viral markers. In contrast, of 110 patient s with normal serum alanine aminotransferase levels, only 14% were ant i-HCV seropositive. In patients with sickle cell anemia, exposure to h epatitis C is common, related to the number of previous transfusions, and the most likely cause of persistently elevated aminotransferase le vels.