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Clinical aspects and outcomes of volunteer blood donors testing positive for hepatitis‐C virus infection in Taiwan: a prospective study
Author(s) -
Liu ChunJen,
Chen PeiJer,
Shau WenYi,
Kao JiaHorng,
Lai MingYang,
Chen DingShinn
Publication year - 2003
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1034/j.1600-0676.2003.00820.x
Subject(s) - medicine , hepatocellular carcinoma , hbsag , cirrhosis , hepatitis c virus , hepatitis b virus , volunteer , liver disease , gastroenterology , immunology , hepatitis c , hepatitis , hepatitis b , virus , virology , biology , agronomy
Background/Aim: The natural history of hepatitis‐C virus (HCV) infection has been explored in volunteer blood donors, but not yet in hepatitis‐B endemic areas. Whether previous or concurrent hepatitis‐B virus (HBV) infection influences the natural history of HCV infection remains unknown. Thus, we followed the anti‐HCV‐positive blood donors who had past or concurrent HBV infection in Taiwan. Methods: From 1992 to 1993, 1588 anti‐HCV reactive volunteer blood donors were referred to us from the Taipei Blood Center and 879 (55%) repeatedly reactive for anti‐HCV were enrolled. Two hundred and forty‐three donors (HCV RNA seropositive rate 49% by polymerase chain reaction (PCR)) received regular follow‐ups (mean period: 4.9 years) with their liver disease status determined mainly by clinical and biochemical parameters, serum alpha‐fetoprotein level and imaging studies. Hepatitis‐C virus genotype and occult HBV infection were determined by PCR‐based assays. Results: Of the initial 879 subjects, 250 (28%) had chronic hepatitis, nine (1%) had liver cirrhosis (LC) and two (0.2%) had hepatocellular carcinoma (HCC) already. In the 243 regularly followed donors, 30% had repeatedly normal serum alanine aminotransferase (ALT) and 70% had more than once elevated ALT. Cirrhosis developed in four (1.6%; follow‐up period range: 2–6 years) and HCC in two (0.8%; follow‐up period: 3 and 4 years, respectively). Distribution of HCV genotype and hepatitis‐B surface antigen (HBsAg) did not differ between those with and those without elevation of ALT. Of the 15 donors with LC and/or HCC, only 1(7%) was positive for both HBsAg and HBV DNA and the other 14 were negative for both HBsAg and serum HBV DNA. Conclusions: Incidentally detected hepatitis‐C was progressive in a small proportion of anti‐HCV‐positive volunteer blood donors in Taiwan. Occult HBV infection played a minimal role in the development of LC in this donor population.