한국성인에서 혈중 C형 간염바이러스 항체의 발현율과 의의

초록

Objectives : The prevalence of anti-HCV among blood donors is about 0.3 to 1.5% when assessed by first or second generation EIA. The significance of anti-HCV in a low risk population such as blood donors is unclear. To estimate the prevalence and significance of anti-HCV (second generation EIA) in Korean adults, we tested 4-RIBA and HCV-RNA RT-PCR in the sera of anti-HCV positive cases with normal serum ALT level. Methods : Serum samples from 5707 adults who visited Health Counseling Center were tested for ALT, HBsAg and anti-HCV by second generation EIA (UBI). Anti-HCV positive cases with normal serum ALT participated in a brief questionnaire and serum samples of them were tested for HCV by a 4-RIBA and HCV-RNA by RT-PCR. Results: The overall prevalence of anti-HCV among Korean adults is 1.77% and among adults with normal serum ALT is 1.45%. History of prior blood transfusion was more frequent in anti-HCV positive cases than anti-HCV negative cases. In 28 anti-HCV positive cases with normal serum ALT level, 4-RIBA was reactive in 35.7% and HCV-RNA was detected in 39.3%. HCV-RNA was detected in 9 of 10 4-RIBA reactive cases but in only 2 of 18 indeterminate or nonreactive cases. All 9 cases with sample/cut-off ratio of greater than 5 in anti-HCV EIA were 4-RIBA reactive and contained HCV-RNA, but only 2 of 19 cases with sample/cut off ratio less than 5 contained HCV-RNA. Conclusion: The overall prevalence of anti-HCV among Korean adults is 1.77%. About 40% of anti-HCV positive cases with normal SALT level contained serum HCV-RNA by RT-PCR. Reactive results of 4-RIBA and high sample/cut-off ratio in anti-HCV EIA correlated well with detection of HCV-RNA by RT-PCR.

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