The Usefulness of the Alanine Aminotransferase Test for Blood Donors

Seo, Dong Hee; Whang, Dong Hee

Abstract

BACKGROUND
The usefulness of the alanine aminotransferase (ALT) test has been questioned after the introduction of anti-Hepatitis C virus (HCV) screening and the HCV nucleic acid test (NAT). A major proportion of the blood discarded according to a positive screening test is composed of ALT-high blood. This study was performed to investigate the usefulness of the ALT test.
METHODS
The number of donors with a high ALT level was analyzed using the 2007 database of 2,028,684 donors. The HBsAg and anti-HCV positive donors were grouped into the ALT<65 group, the ALT=65~89 group and the ALT> or =90 IU/L group. Anti-HBc, anti-HBs and HBV DNA tests were performed for 402 high-ALT samples.
RESULTS
A total of 30,077 (1.5%) donors had an ALT> or =65 IU/L, and 18,594 (61.8%) of them had an ALT of 65~89 IU/L. The mean ages of the groups with ALT<65, 65~89 and > or =90 IU/L were 24, 26 and 25 years, respectively and HBsAg was positive in 0.13, 0.36 and 0.88%, respectively, and anti-HCV was positive in 0.30, 0.39 and 0.52%, respectively. HBV DNA was not detected in the 402 samples with an ALT> or =65 IU/L and a negative HBsAg test.
CONCLUSION
Based on an analysis of a donor databases, the HBV infection rates were higher in blood donors with high ALT. Although HBV DNA was not detected in the high-ALT samples with negative HBsAg, because of the high HBsAg positivity in the high-ALT samples, it would be desirable to retain the ALT screening test when considering the possibility of false negative reactions of the current hepatitis B screening test.