Hepatitis C virus among blood donors: follow‐up study

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Abstract
Background: The exact significance of antibodies to hepatitis C virus (HCV) in blood donors remains unknown. Confirmatory tests of anti‐HCV‐ reactive serum and HCV RNA by polymerase chain reaction (PCR) are used to refute a large proportion of false‐positive results.Study Design and Methods: Ninety‐two blood donors who were anti‐HCV reactive in a first‐generation enzyme‐linked immunosorbent assay (ELISA) were reevaluated 10 months later with a second‐generation ELISA (ELISA‐2) as well as with second‐generation recombinant immunoblot assay (RIBA‐2) and by PCR.Results: Twenty‐five (43.9%) of the 57 ELISA‐2‐positive donors were confirmed as positive by RIBA‐2; of these, 84 percent were HCV RNA positive in PCR. Of the 57 who were still anti‐HCV positive, 46 were followed up and tested again in the same manner 2 years after the first screening. At that time, the pattern was little changed: 94 percent of RIBA‐2‐ and PCR‐positive donors remained positive. Of RIBA‐2‐ and PCR‐positive blood donors, 62 percent had abnormal alanine aminotransferase levels in at least one of the three evaluations. Among the anti‐HCV‐positive donors confirmed by RIBA‐2, 60 percent, versus 12.6 percent in the control group, had a significantly (p < 0.001) more frequent risk factor for HCV infection, due to parenteral exposure to blood.Conclusion: These data confirm a good correlation between RIBA‐2 reactivity and the detection of HCV RNA in a population of anti‐HCV‐ positive blood donors.