Sookoian S, Castaño G, Castiglioni T, Pilar S, Viudez P, González J, Frider B
División Clínica Médica-Hepatología, Hospital Municipal General de Agudos Cosme Argerich, Buenos Aires, Argentina.
Medicina (B Aires). 1997;57(6):699-707.
Our aim was to identify prospectively, with a case-control survey, risk factors for hepatitis C virus (HCV) infection in volunteer blood donors and to assess the histological features and their correlation with transaminase (ALT) level and viremia. In a Liver Unit of a referral-based University Hospital, 248 blood donors were evaluated for risk factors, according to definitive ELISA test and 132 were considered true positive. Of these, 132 anti-HCV(+) blood donors were age and sex-matched with the anti-HCV-negative group (n = 116). There was a high frequency in the anti-HCV(+) group of intravenous drug abuse (IVDA) (22%), history of major surgery (20.4%), tattooing (12.1%), non IVDA (17.4%), and multiple sexual partners or history of sexual transmitted diseases (25.7%). At least one risk factor was identified in 76.52% of the antiHCV(+) donors vs 34.4% in the anti-HCV (-) group (p = 0.000). A total of 71 patients accepted a liver biopsy; chronic liver disease was present in 85.9% (n = 61) (mean Knodell score 6.75). ALT was elevated in 69% (n = 49) and HCV RNA was detectable in 76% of patients. It can be concluded that in our study 76.5% of anti HCV positive blood donors showed at least one risk factor for HCV infection detected by a second highly efficient interview. Twenty two percent admitted to prior intravenous drug use although this disqualifies them for blood donation, but was not identified by the screening process. Most blood donors with anti HCV(+) had chronic hepatitis C regardless of their serum ALT levels. Normal ALT did not exclude liver disease.
我们的目标是通过病例对照研究前瞻性地确定志愿献血者中丙型肝炎病毒（HCV）感染的危险因素，并评估组织学特征及其与转氨酶（ALT）水平和病毒血症的相关性。在一家以转诊为基础的大学医院的肝病科，根据确诊的ELISA检测对248名献血者的危险因素进行了评估，其中132名被认为是真正的阳性。在这些抗HCV（+）献血者中，132名在年龄和性别上与抗HCV阴性组（n = 116）相匹配。抗HCV（+）组中静脉药物滥用（IVDA）的频率很高（22%），有大手术史（20.4%），纹身（12.1%），非IVDA（17.4%），以及多个性伴侣或性传播疾病史（25.7%）。在抗HCV（+）献血者中，76.52%至少有一个危险因素被识别，而抗HCV（-）组为34.4%（p = 0.000）。共有71名患者接受了肝活检；85.9%（n = 61）存在慢性肝病（平均Knodell评分6.75）。69%（n = 49）的患者ALT升高，76%的患者可检测到HCV RNA。可以得出结论，在我们的研究中，76.5%的抗HCV阳性献血者通过第二次高效访谈显示至少有一个HCV感染的危险因素。22%的人承认有过静脉吸毒史，尽管这使他们不符合献血条件，但筛查过程并未发现。大多数抗HCV（+）的献血者患有慢性丙型肝炎，无论其血清ALT水平如何。ALT正常并不能排除肝病。
