沖縄県の献血者におけるＨＣＶ保有者の実態と告知基準の再考

Abstract

Donors showing a weak positive reaction for antibody to hepatitis C virus (anti-HCV) by PHA (25-211) are not subject to notification as HCV carriers. In order to estimate the frequency of HCV-RNA positive donors in low titer PHA positives, serume samples of PHA positive donors were tested for anti-HCV using different EIA test kits (Abbot EIA-2, JCC-2, UBI), and for HCV-RNA by nested PCR. All HCV-RNA positive samples in this study were also positive by all three ETA tests. On the other hand, HCV-RNA were not detected in the samples showing negative in some second generation tests. All three second generation tests were able to identify all of the HCV-RNA positive samples and showed 100% sensitivity.We therefore propose that a new HCV screening and confirmation method using other second generation anti-HCV test (s) and PCR be accepted for notification purposes. First, blood donors should be screened for anti-HCV by PHA, with positive samples showing a PHA titer of 25-211 subject to a second generation confirmation test (s) with which we identify donors likely to be HCV carriers. Second, a PCR test would be done to samples positive by the second generation confirmation test (s). Using this screening method, the persentage of serum samples subject to PCR test were estimated to be 38% of PHA positive donors and 0.1% of the overall donors in Okinawa. Hence, it would seem to be feasible to use the PCR test to determine donors to be notified as HCV carriers.