0
April 3, 1996, Vol 275, No. 13 >
ARTICLE | April 3, 1996

Demographic Determinants of Hepatitis C Virus Seroprevalence Among Blood Donors FREE

Edward L. Murphy, MD, MPH; Stephen Bryzman, PA, MPH; Alan E. Williams, PhD; Harvey Co-Chien, MS; George B. Schreiber, DSc; Helen E. Ownby, PhD; Ronald O. Gilcher, MD; Steven H. Kleinman, MD; Lauri Matijas, MS; Ruth A. Thomson, MPH; George J. Nemo, PhD; A. E. Williams, PhD; C. Nass, PhD; H. Ownby, PhD; D. Waxman, MD; S. Kleinman, MD; S. Hutching; J. Fridey, MD; E. L. Murphy, MD, MPH; M. P. Busch, MD, MPH; R. O. Gilcher, MD; J. W. Smith, MD; G. B. Schrieber; R. Thomson, MPH; G. J. Nemo, PhD; T. Zuck, LLB, MD
[+] Author Affiliations

A complete list of the Retrovirus Epidemiology Donor Study (REDS) Investigators appears at the end of this article.

Reprints: Edward L. Murphy, MD, MPH, Department of Laboratory Medicine, University of California, San Francisco, Box 0884, San Francisco, CA 94143-0884.


JAMA. 1996;275(13):995-1000. doi:10.1001/jama.1996.03530370033027
Text Size: A A A
Published online
Article
References

Objective.  —To measure demographic determinants of hepatitis C virus (HCV) seroprevalence among blood donors in the United States.

Design.  —Cross-sectional epidemiological study.

Setting.  —Five blood centers in different regions of the United States.

Subjects.  —A total of 862 398 consecutive volunteer blood donors with one or more nonautologous donations from March 1992 through December 1993.

Methods.  —Demographic data collection, serological screening with second-generation anti-HCV enzyme immunoassay, and confirmation with anti-HCV recombinant immunoblot.

Results.  —There were 3126 donors with at least one blood donation confirmed HCV-seropositive, for a crude prevalence of 3.6 per 1000. Age-specific HCV sero-prevalence rose from 0.5 per 1000 in donors younger than 20 years to a maximum of 6.9 per 1000 in donors aged 30 to 39 years and declined in older age groups. There was interaction between age and educational attainment, with 30- to 49-year-olds with less than a high school diploma at highest risk of HCV infection (odds ratio [OR], 33.0; 95% confidence interval [CI], 23.0 to 47.2 compared with those younger than 30 years with a bachelor's degree or higher degree). Other independent risk factors for HCV seropositivity included male sex (OR, 1.9; 95% CI, 1.8 to 2.1), black race (OR, 1.7; 95% CI, 1.6 to 1.9), Hispanic ethnicity (OR, 1.3; 95% CI, 1.1 to 1.5), previous blood transfusion (OR, 2.8; 95% CI, 2.5 to 3.1), and first/only time donor status (OR, 4.2; 95% CI, 3.9 to 4.5, compared with repeat donors). Seropositivity for human T-lymphotropic virus types I and II, human immunodeficiency virus, or hepatitis B core antigen was highly associated with HCV seropositivity (OR, 10.4; 95% CI, 9.6 to 11.4 for one vs no marker).

Conclusions.  —Despite a low overall HCV prevalence in blood donors in the United States, there is marked variation in HCV seroprevalence by demographic subgroup, even after controlling for prior blood transfusion, a recognized risk factor for HCV. Further study of the prevalence of other parenteral risk factors such as past injection drug use among blood donors is needed.(JAMA. 1996;275:995-1000)

REFERENCES

1 +
Aach RD, Stevens CE, Hollinger FB, et al.  Hepatitis C virus infection in post-transfusion hepatitis: an analysis with first- and second-generation assays. N Engl J Med . 1991;;325:1325-1329.
2 +
Alter HJ.  Descartes before the horse, I clone, therefore I am: the hepatitis C virus in current perspective. Ann Intern Med . 1991;;115:644-649.
3 +
Esteban R.  Epidemiology of hepatitis C virus infection. J Hepatol . 1993;;17( (suppl 3) ):S67-S71.
4 +
Osmond DH, Padian NS, Sheppard HW, Glass S, Shiboski SC, Reingold A.  Risk factors for hepatitis C virus seropositivity in heterosexual couples. JAMA . 1993;;269:361-365.
5 +
Kelen GD, Green GB, Purcell RH, et al.  Hepatitis B and hepatitis C in emergency department patients. N Engl J Med . 1992;;326:1399-1404.
6 +
Holsen DS, Harthug S, Myrmei H.  Prevalence of antibodies to hepatitis C virus and association with drug abuse and tattooing in a national prison in Norway. Eur J Clin Microbiol Infect Dis . 1993;;12: 673-676.
7 +
Thomas DL, Factor SH, Kelen GD, Washington AS, Taylor E Jr, Quinn TC.  Viral hepatitis in health care personnel at the Johns Hopkins Hospital: the seroprevalence of and risk for hepatitis B virus and hepatitis C virus infection. Arch Intern Med . 1993;; 153:1705-1712.
8 +
Alter MJ, Hadler SC, Judson FN, et al.  Risk factors for acute non-A, non-B hepatitis in the United States and association with hepatitis C virus infection. JAMA . 1990;;264:2231-2235.
9 +
Stevens CE, Taylor PE, Pindyck J.  Epidemiology of hepatitis C virus: a preliminary study of volunteer blood donors. JAMA . 1990;;263:49-53.
10 +
Schoub BD, Johnson S, McAnerney JM, Blackburn NK.  The role of sexual transmission in the epidemiology of hepatitis C virus in black South Africans. Trans R Soc Trop Med Hyg . 1992;;86:431-433.
11 +
Esteban JI, Viladomiu L, Gonzalez A, et al, for the Sentinel Counties Chronic Non-A, Non-B Hepatitis Study Team.  Hepatitis C virus antibodies among risk groups in Spain. Lancet . 1989;;5:294-296.
12 +
Alter MJ, Margolis HS, Krawczynski K, et al.  The natural history of community-acquired hepatitis C in the United States. N Engl J Med . 1992;; 327:1899-1905.
13 +
Nakagiri I, Ichihara K, Ohmoto K, Matsuda N.  Analysis of discordant test results among five second-generation assays for anti-hepatitis C virus antibodies also tested by polymerase chain reaction-RNA assay and other laboratory and clinical tests for hepatitis. J Clin Microbiol . 1993;;31:2974-2980.
14 +
Watanabe J, Fujimura K, Yoshizawa H, et al.  Predictive value of screening tests for persistent hepatitis C virus infection evidenced by viraemia. Vox Sang . 1993;;65:199-203.
15 +
Zuck TF, Thomson RA, Schreiber GB, et al.  The Retrovirus Epidemiology Donor Study (REDS): rationale and methods. Transfusion . 1995;;35:944-951.
16 +
Center for Biologics Evaluation and Research. Memorandum to Registered Blood Establishments: Revised Recommendations for the Prevention of Human Immunodeficiency Virus (HIV) Transmission by Blood and Blood Products . Bethesda, Md: Food and Drug Administration; April 23, 1992;.
17 +
US Bureau of the Census. Statistical Abstract of the United States, 1993 . 113th ed. Washington, DC: US Dept of Commerce; 1993;.
18 +
Williams A, Korelitz J, Thomson R, et al.  Seroprevalence of infectious disease markers in donations from high school and college-aged blood donors. Transfusion . 1993;;33( (suppl) ):59S. Abstract 227.
19 +
Esteban JI, Lopez-Talavera JC, Genesca J, et al.  High rate of infectivity and liver disease in blood donors with antibodies to hepatitis C virus. Ann Intern Med . 1991;;115:443-449.
20 +
Lin CK, Chu R, Li KB, Leong S.  A study of hepatitis C virus antibodies and serum alanine amino transferase in blood donors in Hong Kong Chinese. Vox Sang . 1992;;62:98-101.
21 +
Lee SD, Chan CY, Wang YJ, et al.  Seroepidemiology of hepatitis C virus infection in Taiwan. Hepatology . 1991;;13:830-833.
22 +
Garson JA, Clewley JP, Simmonds P, et al.  Hepatitis C viraemia in United Kingdom blood donors. Vox Sang . 1992;;62:218-223.
23 +
Lai ME, Mazzoleni AP, Farci P, et al.  Markers of hepatitis C virus infection in Sardinian blood donors: relationship with alanine aminotransferase levels. J Med Virol . 1993;;41:282-288.
24 +
Chiaramonte M, Stroffolini T, Caporaso N, et al.  Hepatitis-C virus infection in Italy: a multicentric sero-epidemiological study (a report from the HCV study group of the Italian Association for the Study of the Liver). Ital J Gastroenterol . 1991;;23: 555-558.
25 +
Archer GT, Buring ML, Clark B, et al.  Prevalence of hepatitis C virus antibodies in Sydney blood donors. Med J Aust . 1992;;157:225-227.
26 +
Khan M, Husain M, Yano M, et al.  Comparison of seroepidemiology of hepatitis C in blood donors between Bangladesh and Japan. Gastroenterol Jpn . 1993;;28( (suppl 5) ):28-31.
27 +
Donahue JG, Munoz A, Ness PM, et al.  The declining risk of post-transfusion hepatitis C virus infection. N Engl J Med . 1992;;327:369-373.
28 +
Abdelaal M, Rowbottom D, Zawawi T, Scott T, Gilpin C.  Epidemiology of hepatitis C virus: a study of male blood donors in Saudi Arabia. Transfusion . 1994;;34:135-137.
29 +
Neal KR, Jones DA, Killey D, James V.  Risk factors for hepatitis C virus infection: a case-control study of blood donors in the Trent region (U.K.). Epidemiol Infect . 1994;;112:595-601.
30 +
Kaldor JM, Archer GT, Buring ML, et al.  Risk factors for hepatitis C virus infection in blood donors: a case-control study. Med J Aust . 1992;;157: 227-230.
31 +
Moore SB, Kruger JR, Rakela J, et al.  Blood donors who are repeatedly reactive for hepatitis C virus on enzyme immunoassay and positive on recombinant immunoblot assay: evidence of failure to identify some risk factors. Transfusion . 1995;;35: 308-312.
32 +
Weinstock HS, Bolan G, Reingold AL, Polish LB.  Hepatitis C virus infection among patients attending a clinic for sexually transmitted diseases. JAMA . 1993;;269:392-394.
33 +
Mele A, Sagliocca L, Manzillo G, et al.  Risk factors for acute non-A non-B hepatitis and their relationship to antibodies for hepatitis C virus: a case control study. Am J Public Health . 1994;;84: 1640-1643.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Aach RD, Stevens CE, Hollinger FB, et al.  Hepatitis C virus infection in post-transfusion hepatitis: an analysis with first- and second-generation assays. N Engl J Med . 1991;;325:1325-1329.
2 +
Alter HJ.  Descartes before the horse, I clone, therefore I am: the hepatitis C virus in current perspective. Ann Intern Med . 1991;;115:644-649.
3 +
Esteban R.  Epidemiology of hepatitis C virus infection. J Hepatol . 1993;;17( (suppl 3) ):S67-S71.
4 +
Osmond DH, Padian NS, Sheppard HW, Glass S, Shiboski SC, Reingold A.  Risk factors for hepatitis C virus seropositivity in heterosexual couples. JAMA . 1993;;269:361-365.
5 +
Kelen GD, Green GB, Purcell RH, et al.  Hepatitis B and hepatitis C in emergency department patients. N Engl J Med . 1992;;326:1399-1404.
6 +
Holsen DS, Harthug S, Myrmei H.  Prevalence of antibodies to hepatitis C virus and association with drug abuse and tattooing in a national prison in Norway. Eur J Clin Microbiol Infect Dis . 1993;;12: 673-676.
7 +
Thomas DL, Factor SH, Kelen GD, Washington AS, Taylor E Jr, Quinn TC.  Viral hepatitis in health care personnel at the Johns Hopkins Hospital: the seroprevalence of and risk for hepatitis B virus and hepatitis C virus infection. Arch Intern Med . 1993;; 153:1705-1712.
8 +
Alter MJ, Hadler SC, Judson FN, et al.  Risk factors for acute non-A, non-B hepatitis in the United States and association with hepatitis C virus infection. JAMA . 1990;;264:2231-2235.
9 +
Stevens CE, Taylor PE, Pindyck J.  Epidemiology of hepatitis C virus: a preliminary study of volunteer blood donors. JAMA . 1990;;263:49-53.
10 +
Schoub BD, Johnson S, McAnerney JM, Blackburn NK.  The role of sexual transmission in the epidemiology of hepatitis C virus in black South Africans. Trans R Soc Trop Med Hyg . 1992;;86:431-433.
11 +
Esteban JI, Viladomiu L, Gonzalez A, et al, for the Sentinel Counties Chronic Non-A, Non-B Hepatitis Study Team.  Hepatitis C virus antibodies among risk groups in Spain. Lancet . 1989;;5:294-296.
12 +
Alter MJ, Margolis HS, Krawczynski K, et al.  The natural history of community-acquired hepatitis C in the United States. N Engl J Med . 1992;; 327:1899-1905.
13 +
Nakagiri I, Ichihara K, Ohmoto K, Matsuda N.  Analysis of discordant test results among five second-generation assays for anti-hepatitis C virus antibodies also tested by polymerase chain reaction-RNA assay and other laboratory and clinical tests for hepatitis. J Clin Microbiol . 1993;;31:2974-2980.
14 +
Watanabe J, Fujimura K, Yoshizawa H, et al.  Predictive value of screening tests for persistent hepatitis C virus infection evidenced by viraemia. Vox Sang . 1993;;65:199-203.
15 +
Zuck TF, Thomson RA, Schreiber GB, et al.  The Retrovirus Epidemiology Donor Study (REDS): rationale and methods. Transfusion . 1995;;35:944-951.
16 +
Center for Biologics Evaluation and Research. Memorandum to Registered Blood Establishments: Revised Recommendations for the Prevention of Human Immunodeficiency Virus (HIV) Transmission by Blood and Blood Products . Bethesda, Md: Food and Drug Administration; April 23, 1992;.
17 +
US Bureau of the Census. Statistical Abstract of the United States, 1993 . 113th ed. Washington, DC: US Dept of Commerce; 1993;.
18 +
Williams A, Korelitz J, Thomson R, et al.  Seroprevalence of infectious disease markers in donations from high school and college-aged blood donors. Transfusion . 1993;;33( (suppl) ):59S. Abstract 227.
19 +
Esteban JI, Lopez-Talavera JC, Genesca J, et al.  High rate of infectivity and liver disease in blood donors with antibodies to hepatitis C virus. Ann Intern Med . 1991;;115:443-449.
20 +
Lin CK, Chu R, Li KB, Leong S.  A study of hepatitis C virus antibodies and serum alanine amino transferase in blood donors in Hong Kong Chinese. Vox Sang . 1992;;62:98-101.
21 +
Lee SD, Chan CY, Wang YJ, et al.  Seroepidemiology of hepatitis C virus infection in Taiwan. Hepatology . 1991;;13:830-833.
22 +
Garson JA, Clewley JP, Simmonds P, et al.  Hepatitis C viraemia in United Kingdom blood donors. Vox Sang . 1992;;62:218-223.
23 +
Lai ME, Mazzoleni AP, Farci P, et al.  Markers of hepatitis C virus infection in Sardinian blood donors: relationship with alanine aminotransferase levels. J Med Virol . 1993;;41:282-288.
24 +
Chiaramonte M, Stroffolini T, Caporaso N, et al.  Hepatitis-C virus infection in Italy: a multicentric sero-epidemiological study (a report from the HCV study group of the Italian Association for the Study of the Liver). Ital J Gastroenterol . 1991;;23: 555-558.
25 +
Archer GT, Buring ML, Clark B, et al.  Prevalence of hepatitis C virus antibodies in Sydney blood donors. Med J Aust . 1992;;157:225-227.
26 +
Khan M, Husain M, Yano M, et al.  Comparison of seroepidemiology of hepatitis C in blood donors between Bangladesh and Japan. Gastroenterol Jpn . 1993;;28( (suppl 5) ):28-31.
27 +
Donahue JG, Munoz A, Ness PM, et al.  The declining risk of post-transfusion hepatitis C virus infection. N Engl J Med . 1992;;327:369-373.
28 +
Abdelaal M, Rowbottom D, Zawawi T, Scott T, Gilpin C.  Epidemiology of hepatitis C virus: a study of male blood donors in Saudi Arabia. Transfusion . 1994;;34:135-137.
29 +
Neal KR, Jones DA, Killey D, James V.  Risk factors for hepatitis C virus infection: a case-control study of blood donors in the Trent region (U.K.). Epidemiol Infect . 1994;;112:595-601.
30 +
Kaldor JM, Archer GT, Buring ML, et al.  Risk factors for hepatitis C virus infection in blood donors: a case-control study. Med J Aust . 1992;;157: 227-230.
31 +
Moore SB, Kruger JR, Rakela J, et al.  Blood donors who are repeatedly reactive for hepatitis C virus on enzyme immunoassay and positive on recombinant immunoblot assay: evidence of failure to identify some risk factors. Transfusion . 1995;;35: 308-312.
32 +
Weinstock HS, Bolan G, Reingold AL, Polish LB.  Hepatitis C virus infection among patients attending a clinic for sexually transmitted diseases. JAMA . 1993;;269:392-394.
33 +
Mele A, Sagliocca L, Manzillo G, et al.  Risk factors for acute non-A non-B hepatitis and their relationship to antibodies for hepatitis C virus: a case control study. Am J Public Health . 1994;;84: 1640-1643.

Letters

Submit a Letter
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2012 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems