Determination of alanine aminotransferase in blood donor screening--evidence of its usefulness in the prevention of post-transfusion hepatitis.

A total of 408 HBsAg and anti-HCV-negative patients with elevated ALT levels referred from blood banks were studied. Of these, 359 were followed up. HBsAg and anti-HCV were repeated in the first visit and ALT was checked at a 3 months interval. A liver biopsy was indicated when ALT levels remained abnormal for more than 6 months. Of the patients included, 316/359 (88%) were men, with a mean age of 34 years. In the first visit, 3 (0.8%) patients were anti-HCV positive upon serological reevaluation, with persistence of elevated ALT in all of them. A biopsy revealed chronic hepatitis in all three cases. Twenty-two patients were positive for anti-HBc, 20 of them were immune (anti-HBs positive), one developed anti-HBs after a vaccine dose, and one was HBsAg positive. The present study suggests that ALT can be a useful marker for the detection of hepatitis C virus infected donors in whom technical problems might have occurred in serological screening.