Stevens C E, Aach R D, Hollinger F B, Mosley J W, Szmuness W, Kahn R, Werch J, Edwards V
Ann Intern Med. 1984 Dec;101(6):733-8. doi: 10.7326/0003-4819-101-6-733.
Patients who received transfusions and nontransfused control patients were followed to assess the incidence and cause of post-transfusion hepatitis and to identify donor factors that might relate to risk of hepatitis. We evaluated as risk factors in donors the presence of antibody to hepatitis B virus compared with elevated alanine aminotransferase (ALT) level. Units of blood that were positive for antibody to hepatitis B core antigen (anti-HBc) were associated with a twofold to threefold greater risk of non-A, non-B hepatitis in the recipients than were units without anti-HBc. In the absence of specific serologic tests for non-A, non-B agents, screening of donors for anti-HBc might be considered. Our data suggest that the incidence of non-A, non-B hepatitis might have been reduced by about one third by such screening. However, elevated ALT levels in donors had a similar association with non-A, non-B hepatitis in recipients but would have resulted in fewer units of blood being discarded than would screening for anti-HBc.
对接受输血的患者和未输血的对照患者进行随访，以评估输血后肝炎的发病率和病因，并确定可能与肝炎风险相关的供血者因素。我们将乙肝病毒抗体的存在与丙氨酸转氨酶（ALT）水平升高作为供血者的风险因素进行评估。乙肝核心抗原抗体（抗-HBc）呈阳性的血液单位，其受血者发生非甲非乙型肝炎的风险比无抗-HBc的血液单位高出两到三倍。在缺乏针对非甲非乙型病原体的特异性血清学检测的情况下，可考虑对供血者进行抗-HBc筛查。我们的数据表明，通过这种筛查，非甲非乙型肝炎的发病率可能会降低约三分之一。然而，供血者ALT水平升高与受血者的非甲非乙型肝炎也有类似的关联，但与抗-HBc筛查相比，导致被丢弃的血液单位会更少。
