Study on Evaluation of Alanine Aminotransferase (ALT) as Surrogate Marker in Hepatitis Virus Test

Nucleic acid amplification test (NAT), which wasintroduced by the Japanese Red Cross Societyin October 1999, began to be performed forscreening of blood transfusion formulations inJapan in August 2014. In this study, the precisionof immunological screenings of hepatitis B (HBsAg,HBcAb, and HBsAb), hepatitis C (HCVAb), andhuman immunodeficiency (HIVAb) virus antigensin donated blood were evaluated. In addition, thesensitivity of the alanine aminotransferase (ALT)test for detection of the hepatitis B and C viruseswas re-evaluated.Immunological screenings showed high precisionof detecting the viral antigens. In contrast, the ALTtest showed much lower precision of detecting thepresence of the hepatitis B and C viruses.Results of the NAT and immunological screeningsrevealed that ALT levels in donors were morestrongly correlated with their levels of gammaglutamyltranspeptidase(γGTP) and body massindex (BMI), than with the results of NAT andimmunological screening. Our study indicatesthat elevated level(s) of ALT, were more likely tobe associated with lifestyles factors such as highintake of alcohol or obesity than with infection.Therefore, ALT may be excluded as surrogatemarkers of HBV, HCV, and HIV in donated blood.