Alfredo Alberti, MD; Liliana Chemello, MD; Daniela Cavalletto, MD; Alessandro Tagger, MD; Alessandro Dal Canton, MD; Nicola Bizzaro, MD; Giuseppe Tagariello, MD; Arturo Ruol, MD
Objective: To evaluate the specificity of antibodies to hepatitis C virus (anti-HCV) and their relation to liver disease in blood donors.
Design: Case series of consecutive blood donors found positive for anti-HCV by enzyme-linked immunosorbent assay (ELISA). Patients were evaluated for antibody specificity using a recombinant immunoblotting assay (RIBA) and were evaluated for bio-chemical evidence of liver disease. Patients showing increased alanine aminotransferase (ALT) levels had a liver biopsy.
Setting: University hospital.
Participants: Fifty consecutive blood donors found to be anti-HCV positive on both an initial and repeat ELISA. Inclusion criteria were as follows: an absence of hepatitis B surface antigens and non-organ-specific autoantibodies; a daily alcohol intake of < 50 g; no history of recent hepatotoxic drug use; and normal serum levels of alpha1 antitrypsin, ceruloplasmin, and copper.
Main Results: Anti-HCV positivity was confirmed by RIBA in only 13 of 50 donors (26%) who had positive ELISA results. These 13 donors had an elevated ALT level and histologic evidence of chronic hepatitis, which was active in 8 patients (62%) and had already produced cirrhosis in 2 patients (15%). In contrast, the 17 donors with an intermediate RIBA pattern had only mild and often nonspecific histologic liver abnormalities. The 20 patients with a negative RIBA result had normal ALT levels.
Conclusion: In blood donors, the anti-HCV RIBA is not only more specific than the anti-HCV ELISA, but is also useful in identifying patients who have an underlying chronic liver disease.
Alberti A, Chemello L, Cavalletto D, Tagger A, Dal Canton A, Bizzaro N, et al. Antibody to Hepatitis C Virus and Liver Disease in Volunteer Blood Donors. Ann Intern Med. ;114:1010–1012. doi: 10.7326/0003-4819-114-12-1010
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Published: Ann Intern Med. 1991;114(12):1010-1012.
Gastroenterology/Hepatology, Liver Disease.
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