da Silva Cardoso M, Koerner K, Epple S, Kubanek B
German Red Cross Blood Bank, Ulm.
Ann Hematol. 1993 Mar;66(3):147-51. doi: 10.1007/BF01697626.
In Germany, transmission of hepatitis C virus by blood transfusion is prevented by screening the donations for anti-HCV and ALT. The specificity of the anti-HCV screening in low seroprevalence populations has been questioned. In order to evaluate this screening policy we wanted to estimate the prevalence of viremic and potentially infectious donors by the HCV-RNA polymerase chain reaction (PCR) in our donor population of southern Germany. Donors (n = 301) were divided into four subgroups according to anti-HCV status and ALT levels. HCV sequences were detected by nested PCR, using primers for the most conserved region of the viral genome. The recombinant immunoblot assay (RIBA-4) was applied to the same samples. PCR detected 4.2% HCV-RNA carriers in the subgroup anti-HCV-/ALT-; 3% in the subgroup anti-HCV-/ALT+; 19.4% in the subgroup anti-HCV+/ALT-; and 59.4% in the subgroup anti-HCV+/ALT+. It was concluded that, on the one hand, the lack of specificity of the anti-HCV ELISA gives rise to many false-positive results; on the other hand, a minority of infected donations will not be detected by the screening procedure. ALT in conjunction with anti-HCV improves the quality of screening for potentially infectious donors.
在德国，通过筛查献血者的抗丙型肝炎病毒（anti-HCV）和丙氨酸氨基转移酶（ALT）来预防输血传播丙型肝炎病毒。抗-HCV筛查在低血清流行率人群中的特异性受到质疑。为了评估这一筛查政策，我们想通过丙型肝炎病毒RNA聚合酶链反应（PCR）来估计德国南部献血人群中病毒血症和潜在感染性献血者的流行率。根据抗-HCV状态和ALT水平，将301名献血者分为四个亚组。使用针对病毒基因组最保守区域的引物，通过巢式PCR检测HCV序列。对相同样本进行重组免疫印迹分析（RIBA-4）。PCR在抗-HCV-/ALT-亚组中检测到4.2%的HCV-RNA携带者；在抗-HCV-/ALT+亚组中为3%；在抗-HCV+/ALT-亚组中为19.4%；在抗-HCV+/ALT+亚组中为59.4%。得出的结论是，一方面，抗-HCV ELISA缺乏特异性导致许多假阳性结果；另一方面，少数受感染的献血将无法通过筛查程序检测出来。ALT与抗-HCV联合使用可提高对潜在感染性献血者的筛查质量。
