Hepatitis C infection in BMT patients.

Eighty-five patients who had undergone BMT for malignant blood disease or aplastic anemia at the Helsinki University Central Hospital, Finland were tested for hepatitis C antibodies (anti-HCV). Eight (9.4%) patients were anti-HCV positive according to a second generation enzyme linked immunosorbent assay (ELISA). Seven (87.5%) of the ELISA positive results could be confirmed by a supplemental test, the second generation recombinant immunoblot assay (RIBA-4). Two patients were constantly seropositive, one patient was seropositive prior to BMT but became antibody negative soon after BMT, and four patients seroconverted after BMT. Six of the seven confirmed anti-HCV positive patients had biochemical evidence of liver damage, but none had fulminant hepatitis or hepatic failure. Liver enzyme abnormalities consistent with a possible non-A, non-B hepatitis were significantly more prevalent among the seropositive than seronegative patients (p < 0.05). The intensive immunosuppression associated with BMT seemed to have little effect on the ability to produce antibodies for hepatitis C virus (HCV). The pattern of antibodies towards different HCV antigens in RIBA-4 was inconsistent, but the present results suggest that antibodies to a core antigen (C22) may, in some cases, be detected earlier than other HCV antibodies during early HCV infection. Moreover, ELISA became positive earlier than RIBA-4 in some patients.