Risk factors for hepatitis C virus infection among blood donors in Beijing and implications for improving the pretesting donor screening process

BACKGROUND: The objective was to determine risk factors of hepatitis C virus (HCV) infection in blood donors in Beijing. STUDY DESIGN AND METHODS: A cross-sectional study was conducted in a total of 112 volunteer blood donors at Beijing Red Cross Blood Center (BRCBC) who were identified between January 2002 and December 2003 due to isolated HCV antibody reactivity at a donor screening procedure. The donors were recalled and interviewed about possible risk factor history. Additional blood samples were tested in repeated enzyme immunoassay, recombinant immunoblot assay, and nested reverse transcription-polymerase chain reaction. Chi-square test, analysis of variance, and multivariate logistic regression analysis were conducted to examine associations between HCV serostatus and potential risk factors. RESULTS: Among donors identified with isolated HCV antibody reactivity at donor screening, the prevalence of confirmed HCV infection was 31.3 percent (95% confidence interval [CI], 22.0%-39.2%) and indeterminate HCV infection was 22.3 percent (95% CI, 14.7%-30.3%), and the negative prevalence was 46.4 percent (95% CI, 37.5%-56.1%). The confirmed HCV cases were more likely than the indeterminate HCV cases to have the histories of previous transfusion, plasma donation, and hepatitis infection or elevated alanine aminotransferase (ALT), whereas the HCV-negative subjects were least likely to have the above histories (p < 0.05). CONCLUSION: Histories of blood transfusion before 1995, plasma donation, previous hepatitis infection, or elevated ALT were risk factors for HCV infection among blood donors in Beijing.