Shakil A O, Conry-Cantilena C, Alter H J, Hayashi P, Kleiner D E, Tedeschi V, Krawczynski K, Conjeevaram H S, Sallie R, Di Bisceglie A M
National Institutes of Health, Bethesda, Maryland, USA.
Ann Intern Med. 1995 Sep 1;123(5):330-7. doi: 10.7326/0003-4819-123-5-199509010-00002.
To assess the clinical significance of antibody to hepatitis C virus (anti-HCV) in volunteer blood donors.
Prospective cohort study.
National Institutes of Health Clinical Center, a tertiary referral research hospital.
60 anti-HCV-positive blood donors, divided into three groups of 20 persons each: Group I had normal alanine aminotransferase levels, group II had levels elevated to values less than twice the normal range, and group III had levels elevated to values greater than twice the normal range.
Medical history, results of laboratory and virologic testing, and percutaneous liver biopsy findings.
Participants with normal alanine aminotransferase levels were older and more often female than those with abnormal levels. The source of infection, duration of disease, symptom score, and amount of alcohol consumed were similar in the three groups. Hepatitis C virus RNA was detectable in 85% of participants, more commonly in the groups with elevated alanine aminotransferase levels (95%) than in the group with normal levels (65%); however, titers were similar in all groups. Examination of liver biopsy specimens showed chronic hepatitis in 54 participants (90%) and cirrhosis in 1 participant. The only normal liver biopsy specimens (n = 3) were those from participants who were HCV RNA negative and had normal alanine aminotransferase levels.
Most blood donors with anti-HCV have chronic hepatitis C regardless of their serum alanine aminotransferase levels. Donors with normal alanine aminotransferase levels and no HCV RNA in their serum generally have normal liver histologic findings or minimal changes and have probably recovered from HCV infection.
评估丙型肝炎病毒抗体（抗-HCV）在无偿献血者中的临床意义。
前瞻性队列研究。
国立卫生研究院临床中心，一家三级转诊研究医院。
60名抗-HCV阳性献血者，分为三组，每组20人：第一组丙氨酸氨基转移酶水平正常，第二组丙氨酸氨基转移酶水平升高至正常范围的两倍以内，第三组丙氨酸氨基转移酶水平升高至正常范围的两倍以上。
病史、实验室和病毒学检测结果以及经皮肝活检结果。
丙氨酸氨基转移酶水平正常的参与者比丙氨酸氨基转移酶水平异常的参与者年龄更大，女性更多。三组的感染源、病程、症状评分和饮酒量相似。85%的参与者可检测到丙型肝炎病毒RNA，丙氨酸氨基转移酶水平升高组（95%）比正常水平组（65%）更常见；然而，所有组的病毒滴度相似。肝活检标本检查显示54名参与者（90%）患有慢性肝炎，1名参与者患有肝硬化。仅有的正常肝活检标本（n = 3）来自血清HCV RNA阴性且丙氨酸氨基转移酶水平正常的参与者。
大多数抗-HCV阳性的献血者无论其血清丙氨酸氨基转移酶水平如何，均患有慢性丙型肝炎。丙氨酸氨基转移酶水平正常且血清中无HCV RNA的献血者通常肝组织学检查结果正常或仅有轻微改变，可能已从HCV感染中恢复。
