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, et al. Antibody to Hepatitis C Virus and Liver Disease in Volunteer Blood Donors. Ann Intern Med. 1991;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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