Long‐term follow‐up of and infectivity in blood donors with hepatitis C antibodies and persistently normal alanine aminotransferase levels

Rossini, Angelo; Gazzola, Gian Biattista; Ravaggi, Antonella; Agostinelli, Enrica; Biasi, L.; Albertini, A; Radaeli, Enrico; Cariani, Elisabetta

doi:10.1046/j.1537-2995.1995.35295125731.x

Cited by 20 publications

(11 citation statements)

References 20 publications

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“…In 87.9% of HCV-RNApositive donations, the presence of anti-HCV was also confirmed by RIBA-2. This proportion is greater than the 36% of RIBA-2 positive cases reported in similar individuals in studies conducted in Italy 18,22 and France 24 and 39% observed in USA 11 . In Spain, 33-63% of anti-HCV positive was also RIBA-2 positive 19,23 .…”

Section: Discussionmentioning

confidence: 52%

Diagnosis of hepatitis C virus in Brazilian blood donors using a reverse transcriptase nested polymerase chain reaction: comparison with enzyme immunoassay and recombinant protein immunoblot assay

Gonçales

Costa

Vassallo

et al. 2000

Rev. Inst. Med. trop. S. Paulo

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SUMMARYScreening blood donations for anti-HCV antibodies and alanine aminotransferase (ALT) serum levels generally prevents the transmission of hepatitis C virus (HCV) by transfusion. The aim of the present study was to evaluate the efficiency of the enzyme immunoassay (EIA) screening policy in identifying potentially infectious blood donors capable to transmit hepatitis C through blood transfusion. We have used a reverse transcriptase (RT)-nested polymerase chain reaction (PCR) to investigate the presence of HCV-RNA in blood donors. The prevalence of HCV-RNA positive individuals was compared with the recombinant immunoblot assay (RIBA-2) results in order to assess the usefulness of both tests as confirmatory assays. Both tests results were also compared with the EIA-2 OD/C ratio (optical densities of the samples divided by the cut off value). ALT results were expressed as the ALT quotient (qALT), calculated dividing the ALT value of the samples by the maximum normal value (53UI/l) for the method. Donors (n=178) were divided into five groups according to their EIA anti-HCV status and qALT: group A (EIA³3, ALT<1), group B (EIA³3, ALT>1), group C (1£EIA<3, ALT<1), group D (1£EIA<3, ALT>1) and group E (EIA£0.7). HCV sequences were detected by RT-nested PCR, using primers for the most conserved region of viral genome. RIBA-2 was applied to the same samples. In group A (n=6), all samples were positive by RT-nested PCR and RIBA-2. Among 124 samples in group B, 120 (96.8%) were RIBA-2 positive and 4 (3.2%) were RIBA-2 indeterminate but were seropositive for antigen c22.3. In group B, 109 (87.9%) of the RIBA-2 positive samples were also RTnested PCR positive, as well as were all RIBA-2 indeterminate samples. In group C, all samples (n=9) were RT-nested PCR negative: 4 (44.4%) were also RIBA-2 negative, 4 (44.4%) were RIBA-2 positive and 1 (11.1%) was RIBA-2 indeterminate. HCV-RNA was detected by RT-nested PCR in 3 (37.5%) out of 8 samples in group D. Only one of them was also RIBA-2 positive, all the others were RIBA-2 indeterminate. All of the group E samples (controls) were RT-nested PCR and RIBA-2 negative. Our study suggests a strong relation between anti-HCV EIA-2 ratio ³ 3 and detectable HCV-RNA by RT-nested PCR. We have also noted that blood donors with RIBA-2 indeterminate presented a high degree of detectable HCV-RNA using RT-nested PCR (75%), especially when the c22.3 band was detected.

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Section: Discussionmentioning

confidence: 52%

Diagnosis of hepatitis C virus in Brazilian blood donors using a reverse transcriptase nested polymerase chain reaction: comparison with enzyme immunoassay and recombinant protein immunoblot assay

Gonçales

Costa

Vassallo

et al. 2000

Rev. Inst. Med. trop. S. Paulo

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“…This proportion is greater than the 36% of RIBA-2 positive cases reported in similar individuals in studies conducted in Italy 16,19 and France 22 and the 39% observed in the USA 13 . In Spain, 33-63% of anti-HCV positive donors were also RIBA-2 positive 17,20 .…”

Section: Discussionmentioning

confidence: 54%

A clinical, epidemological, laboratorial, histological and ultrasonographical evaluation of anti-HCV EIA-2 positive blood donors

Gonçales

Stucchi

Pavan

et al. 2000

Rev. Inst. Med. trop. S. Paulo

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SUMMARYBetween 1992 and 1997, 790 blood donors with anti-HCV EIA-2 strongly reagent (relationship between the sample optical density/cut-off > 3) detected at the blood bank serological screening, were evaluated in ambulatory environment. They were all negative for Chagas disease, syphilis, hepatitis B (HBsAg) and AIDS. Blood samples were collected at the first ambulatorial evaluation, for hemogram, biochemical tests and new serological tests for HCV (anti-HCV EIA-2). In blood samples of 226 repeatedly reagent anti-HCV EIA-2 blood donors, supplementary "immunoblot" test for HCV (RIBA-2) was used. In 209 donors, the presence of HCV-RNA was investigated by the PCR test. The abdominal ultrasonography was realized in 366 donors. In 269 patients liver biopsy was performed for the histopathological study. The follow-up of blood donors showed that 95.6% were repeatedly EIA-2 reagent, 94% were symptomless and denied any hepatitis history, with only 2% mentioning previous jaundice. In 47% of this population at least one risk factor has been detected for the HCV transmission, the use of intravenous drugs being the main one (27.8%). Blood transfusion was the second factor for HCV transmission (27.2%). Hepatomegaly was detected in 54% of the cases. Splenomegaly and signs of portal hypertension have seldom been found in the physical examination, indicating a low degree of hepatic compromising in HCV. Abdominal ultrasound showed alterations in 65% of the subjects, being the steatosis the most frequent (50%). In 83.5% of the donors submitted to the liver biopsy, the histopathological exam showed the presence of chronic hepatitis, usually classified as active (89%) with mild or moderate grade in most of the cases (99.5%). The histopathological exam of the liver was normal in 1.5% of blood donors. The RIBA-2 test and the HCV-RNA investigation by PCR were positive in respectively 91.6 and 75% of the anti-HCV EIA-2 reagent donors. The HCV-RNA research was positive in 82% of the RIBA-2 positive subjects, in 37.5% of the indeterminate RIBA-2 donors and in 9% of the negative RIBA-2 donors. Chronic hepatitis has also been observed in 50% of the histopathological exams of the anti-HCV EIA-2 reagent donors which were indeterminate RIBA-2. Among 18 blood donors with minimal changes histopathological exam 11 (61%) were HCV-RNA positive. Our blood donors anti-HCV reagent generally had clinical, laboratorial and histopathological features observed in patients with chronic HCV hepatitis and a high proportion could be identified in interviews and medical evaluation realized in blood blanks. Generally, these HCV infected donors are identified and discharged only by the serological tests results.

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“…Twenty five patients (51%) had chronic hepatitis, most of them grading from A1 to A2. Seventeen out of 25 patients (68%) had fibrosis, while other studies reported results ranging from 41% to 90% (22,26) . Interestingly, one of our patients showed cirrhosis.…”

Section: Discussionmentioning

confidence: 77%

“…All of these responded to vitamin K replacement, thus allowing the performance of liver biopsy. Interestingly, ROSSINI et al (22) verified that elevated levels of gammaglobulin were predictive of viremia.…”

Section: Discussionmentioning

confidence: 99%

“…Serum HA levels increase in patients with chronic hepatitis C; and this is related to the degree of hepatic fibrosis, and therefore HA could be used as a non-invasive method for the evaluation of the extension of fibrosis in chronic hepatitis C patients (22) . Recent studies have reported that HA is better than PIIIP as a marker of fibrosis because it allows a better distinction of patients with extensive fibrosis in relation to patients with mild or no fibrosis.…”

Section: Discussionmentioning

confidence: 99%

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Relationship between serum concetrations of type III procollagen, hyluronic acid and histopathological findings in the liver of HCV-positive blood donors

Camacho

Silveira

Oliveira

et al. 2007

Arq. Gastroenterol.

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-Background -Serologic markers have been proposed for monitoring hepatic fibrosis in chronic liver disease. Among fibrosis markers, type III procollagen (PIIIP) and hyaluronic acid have been studied in these patients. Aim -To evaluate the association between these serum markers with histological findings. Methods -A prospective cross-sectional study was carried out with HCV-positive blood donors. The studied population included men and women whose age ranged from 18 to 60 years, with elevated liver function tests [ALT levels ≥ 1.5 times the normal value and alterations of two or more of the following: any changes in the levels of ALT, aspartate aminotransferase, conjugated bilirrubin, gammaglobulin, gammaglutamyltranspeptidase, albumin, platelet count; alkaline phosphatase levels ≥1.5 times the normal value, or prothrombin time below 70% and above 60%]. Fourty-nine patients were submitted to liver biopsy, blood analysis of PIIIP, hyaluronic acid, besides liver function tests.

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Long‐term follow‐up of and infectivity in blood donors with hepatitis C antibodies and persistently normal alanine aminotransferase levels

Cited by 20 publications

References 20 publications

Diagnosis of hepatitis C virus in Brazilian blood donors using a reverse transcriptase nested polymerase chain reaction: comparison with enzyme immunoassay and recombinant protein immunoblot assay

Diagnosis of hepatitis C virus in Brazilian blood donors using a reverse transcriptase nested polymerase chain reaction: comparison with enzyme immunoassay and recombinant protein immunoblot assay

A clinical, epidemological, laboratorial, histological and ultrasonographical evaluation of anti-HCV EIA-2 positive blood donors

Relationship between serum concetrations of type III procollagen, hyluronic acid and histopathological findings in the liver of HCV-positive blood donors

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