Abstract
The policy of testing all blood donors for the presence of HBsAg has not succeeded in eliminating posttransfusion hepatitis. This is because the majority of cases are non-A, non- B (NANB) hepatitis; serologic tests for carriers of this disease are not available. The incidence of apparent NANB infection among blood recipients maybe as high as 10-12%. Recent studies suggest that blood donors with elevated alanine aminotransferase (ALT) levels are more often associated with this infection in recipients. Implementation of donor ALT testing would result in a number of problems including attrition of the blood resource, difficulties in test standardization and interpretation, development of a rationale for donordeferral and counseling, and significant additional costs for provision of blood. There is a lack of information about the extent and severity of clinically significant posttransfusion NANB hepatitis. A careful analysis of the advantages and disadvantages of ALT testing should be completed before any measures are taken to develop policies in this area.
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