Hepatitis C Viremia and Serologic Profile in Post-Transfusion Non-A, Non-B Hepatitis

Serial serum samples from 19 patients with post-transfusion hepatitis C, followed for an average of 8 years, were tested for HCV antibody by individual synthetic peptide-based ELISA (core, NS3/4, El, E2/NS1 and NS5) and four-antigen RIB A, and for HCV-RNA by PCR amplification with nested primers from 5′ noncoding region and type-specific primers from core and NS5 regions. Ten patients progressed from acute to chronic hepatitis and 9 recovered. An expanded antibody pattern seems to correlate with a higher frequency of HCV-RNA-positive patients. The disappearance with time of HCV antibody was observed only in patients who cleared HCV. The persistence of HCV-RNA in 5 of 9 recovered patients suggests the existence of a ‘healthy’ carrier state of HCV. Most patients with chronic hepatitis had type I or II HCV infection, whereas most asymptomatic HCV carriers were infected with type IV HCV.