Hepatitis C Virus Prevalence and Clearance among US Blood Donors, 2006–2007: Associations with Birth Cohort, Multiple Pregnancies, and Body Mass Index

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http://www.journals.uchicago.edu/doi/abs/10.1086/654882

The Journal of Infectious Diseases 2010;202:576–584

© 2010 by the Infectious Diseases Society of America. All rights reserved.

0022-1899/2010/20204-0010$15.00

DOI: 10.1086/654882

MAJOR ARTICLE

Hepatitis C Virus Prevalence and Clearance among US Blood Donors, 2006–2007:

Associations with Birth Cohort, Multiple Pregnancies, and Body Mass Index

L. ,1,2

Junyong Fang,3

Yongling Tu,3

Ritchard Cable,4

D. Hillyer,5,6

Sacher,7

Darrell Triulzi,8

Jerome L. Gottschall,9 and

P. Busch,2

for the Retrovirus Epidemiology Donor Studya

1University of California, San Francisco, and 2Blood Systems Research Institute,

San Francisco, California; 3Westat, Rockville, land; 4American Red Cross

Blood Services, New England Division, Farmington, Connecticut; 5Emory University

and 6American Red Cross Blood Services, Southern Region, Atlanta, Georgia;

7Hoxworth Blood Center, Cincinnati, Ohio; 8Institute for Transfusion Medicine,

Pittsburgh, Pennsylvania; and 9Blood Center of Wisconsin, Milwaukee Wisconsin

Background.During the period 1992–1993, the prevalence of hepatitis C virus

(HCV) antibodies (antiâ€HCV) among US blood donors was 0.36%, but contemporary

data on the prevalence of antibody to HCV and the prevalence of HCV RNA are

lacking.

Methods.We performed a large, crossâ€sectional study of blood donors at 6 US

blood centers during 2006–2007. Antiâ€HCV was measured with enzymeâ€linked

immunosorbent assay followed by immunoblot, and HCV RNA was measured with

nucleic acid testing. Adjusted odds ratios (aORs) were derived using

multivariable logistic regression.

Results.Of 959,281 donors, 695 had antiâ€HCV detected (prevalence, 0.072%). Of

those with antiâ€HCV, 516 (74%) had test results positive for HCV RNA, and 179

(26%) had test results that were negative for HCV RNA. Compared with the

prevalence during the period 1992–1993, prevalence during 2006–2007 was

lower and peaked in older age groups. Antiâ€HCV was associated with a body mass

index (BMI)>30 (aOR, 0.6; 95% confidence interval [CI], 0.5–0.8), and among

women, it was associated with higher gravidity (aOR for 5 vs 0 pregnancies, 3.2;

95% CI, 1.9–5.4). HCV RNA negative status was associated with black race (aOR,

0.4; 95% CI, 0.2–0.7), having more than a high school education (aOR, 1.6; 95%

CI, 1.1–2.4), and BMI>30 (aOR, 2.4; 95% CI, 1.4–3.9).

Conclusions.Decreasing HCV prevalence is most likely attributable to culling of

seropositive donors and a birth cohort effect. We found new associations between

antiâ€HCV prevalence and gravidity and obesity. Recently discovered genetic

factors may underlie differences in HCV RNA clearance in black donors.

Received 3 December 2009; accepted 12 March 2010; electronically published 9

July 2010.

Reprints or correspondence: Dr L. , 270 Masonic Ave, San Francisco,

CA 94118 (murphy@...).

Potential conflicts of interest: none reported.

Financial support: National Heart, Lung, and Blood Institute contracts

N01â€HBâ€47168, â€47169, â€47170, â€47171, â€47172, â€47174, â€47175 and

â€57181 and a career award (K24â€HLâ€75036 to E.L.M.).

Presented in part: AABB Annual Meeting, 4–7 October 2008, Montreal, Canada

[abstract S123â€040A], and the International Society of Blood Transfusion

European Regional Meeting, 21–25 March 2009, Cairo, Egypt [abstract Pâ€078].

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