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Biochemical, virological and histopathological changes in Danish blood donors with antibodies to hepatitis C virus
K E Grønbaek1, O J Jensen, H B Krarup
1Department of Clinical Chemistry, Amtssygehuset i Gentofte.
Background:
Previous studies have indicated that the presence of antibodies to Hepatitis C virus (HCV) is indicative of current HCV infection irrespective of S-alanine aminotransferase (S-ALT) values.
Study Design And Methods:
Over three years, all confirmed anti-HCV-positive blood donors form the Blood Banks of Copenhagen County were consecutively evaluated. Seven women and 14 men with a median age of 34 years were included. Serum HCV-RNA was measured with an in-house developed single PCR. Liver biopsies were classified according to standard criteria.
Results:
All were asymptomatic at presentation with no history of liver disease. Previous intravenous drug abuse and/or tattooing were identified in 16. Seventeen blood donors were evaluated biochemically and histologically. Serum HCV-RNA was detectable in 14, all of whom had histopathological changes in their liver biopsy including chronic active hepatitis and active cirrhosis. Twelve of the 14 HCV-RNA-positive donors had elevated S-ALT. In the three HCV-RNA-negative donors, S-ALT was normal. Two of these had normal liver biopsies, whereas the third had minimal changes.
Conclusion:
To diagnose and evaluate the activity of chronic HCV infection, liver biopsy and HCV-RNA assessment are essential in confirmed anti-HCV-positive individuals irrespective of symptoms and S-ALT levels.