Interet du dosage de L'ALAT dans la prevention des hepatites post transfusionnelles. Etude prospective a propos de 1180 donneurs de sang du sahel Tunisien

ABSTRACT

In Tunisia, regular serological tests for prevention of blood transmitted hepatitis consist in the research of HBS antigen and HCV antibodies. Our purpose in this study is to estimate the prevalence of hypertransaminasemia in blood donors and to determinate to what extent it could prevent blood transmited hepatitis. Therefore we have assessed ALAT sera level in 1180 blood donors. It rate is considered elevated if higher than twofold the normal rate [> N= 40UI/I]. Donors with high ALAT level were summoned three months later after their blood gift to undergo clinical examination and a new serological test, researching seroconversion of HBS Ag and HCV antibodies. With regarding to estimation of residuel HCV infection risk, we were based on M.P Busch's data. Hypertransaminasemia was modified in 134 individuals [11.5%]. Only 67 had replied to our summons. Alcoholism was involved in one case. Smoking was found in most of male donors. We had discovered neither weight excess nor drug or medecines consumption which could explain increasing ALAT. New serological list had revealed seroconversion for HCV antibodies in ELISA but with undeterminated profile in immunoblot [anti NS5 solely]. PCR was not carried out. Residual infection risk being considered. Use of hypertransaminasemia detection in blood donors shoud prevent nearly 1.67 blood transmitted hepatitis per million transfusions units. However if we consider shortage in blood derivates in Tunisia, such a decision should be comprehensively weighted numerous blood donors will be moved aside