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

The Journal of Infectious Diseases 2010;202:000–000
© 2010 by the Infectious Diseases Society of America.
All rights reserved.
0022-1899/2010/20204-00XX$15.00
DOI: 10.1086/654882

MAJOR ARTICLE

Edward L. Murphy 1,2; Junyong Fang 3; Yongling Tu 3; Ritchard Cable 4; Christopher D. Hillyer 5,6; Ronald Sacher 7; Darrell Triulzi 8; Jerome L. Gottschall 9; and Michael P. Busch 2

1 University of California, San Francisco, and 2 Blood Systems Research Institute, San Francisco, California; 3 Westat, Rockville, Maryland; 4 American Red Cross Blood Services, New England Division, Farmington, Connecticut; 5 Emory University and 6 American Red Cross Blood Services, Southern Region, Atlanta, Georgia; 7 Hoxworth Blood Center, Cincinnati, Ohio; 8 Institute for Transfusion Medicine, Pittsburgh, Pennsylvania; and 9 Blood Center of Wisconsin, Milwaukee Wisconsin

Background.
During the period 1992–1993, the prevalence of hepatitis C virus (HCV) antibodies (anti‐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, cross‐sectional study of blood donors at 6 US blood centers during 2006–2007. Anti‐HCV was measured with enzyme‐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.
959,281 donors, 695 had anti‐HCV detected (prevalence, 0.072%). Of those with anti‐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. Anti‐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 anti‐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.

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