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In a prospective study of 16,756 consecutive blood donors, we found 54 donors (0.3%) to be anti-hepatitis C virus (HCV)-positive by a first-generation enzyme-linked immunosorbent assay. After retesting, 18 donors were confirmed positive or indeterminate by a second-generation recombinant immunoblot assay. Sixteen of these donors were found positive by a second-generation enzyme-linked immunosorbent assay, and 15 of these were positive by HCV polymerase chain reaction with two primer sets. Nine donors (50%) had a history of drug abuse. In 15 donors found positive by a second-generation enzyme-linked immunoblot assay liver biopsy specimens were taken after at least 6 months' follow-up. In all except one hepatitis C RNA-negative donor, histologic abnormalities were observed, even when alanine aminotransferase (ALAT) levels were continuously normal or only moderately elevated. The abnormalities were less pronounced in these donors (n = 5) than in donors with ALAT levels increased more than twice the upper normal limit (p0.05). In conclusion, we found the proportion of previous drug abusers in anti-HCV-positive blood donors to be high. We confirm that the presence of anti-HCV (second generation) usually, and HCV-RNA always, seems to indicate ongoing infection--also when ALAT levels are normal. Our study further suggests that low-activity hepatitis, evaluated by ALAT levels, may indicate a milder disease.

We present the results of serum-cholesterol measurements in 956 blood donors and an evaluation of their motivation for dietary changes based on answers to a questionnaire. The mean serum-cholesterol level was 5.5 mmol/l for women and 5.7 mmol/l for men, with an increase in serum-cholesterol with age. Motivation for dietary changes was food, since 85% answered that they would change their diet if their serum-cholesterol was high. 65% of those who knew their serum-cholesterol to be high before this study had changed their diet. 38% of the smokers answered that they would stop smoking if their serum-cholesterol was high. Eight to 14 months later, serum-cholesterol measurements in 201 of the blood donors showed that 72.4% of those with serum-cholesterol greater than 6 mmol/l had changed their diet and that these had reduced their serum-cholesterol by an average 10.6%.