Evaluation of Anti-HCV ELISA Seropositivity in Voluntary Blood Donors: A Proposal for Donor Counseling Strategies

Abstract

Objective: To evaluate the anti-HCV (hepatitic C virus) reactivity for the development of an individual donor counseling strategy which would prevent unnecessary donor deferment without compromising the safety of blood products. Design: All donors, who were repeatedly reactive in the Ortho HCV ELISA as well as the Abbott HCV EIA screening tests were selected for follow-up testing. At follow-up three screening tests (Ortho, Abbott, and UBI HCV EIA) and two confirmation tests (Riba 4 and PCR HCV RNA) were performed. During the counseling interview risk factors and medical history were recorded. Setting: Blood bank Zuid-Limburg, Maastricht, the Netherlands; estimated donor population 17,500. Participants: A total of 54 donors could be completely evaluated. Results: The participants could be divided into five different categories, requiring specific donor information and different blood bank policies. The donors in categories 1 and 2 (n = 11) had false-positive reactions and were kept active. Category 3 and 4 donors (n = 28) showed indeterminate results and were permanently or temporarily excluded. Finally, in category 5 donors (n = 15) a HCV infection could be diagnosed on the basis of either Riba-positive or PCR-positive results. Conclusions: An anti-HCV screening policy should include a careful evaluation and confirmation of antibody reactivity. A strategy is suggested which allows an individual donor counseling, prevents unnecessary donor deferment, and avoids unnecessary fear of seropositivity