502

CLIN I CAL AND LABORATORY FINDINGS ON 8 SAMPLES FROM ANTI-C-100 NEGATIVE HAEMO PHI LIACS

CPH= chronic persistent hepatitis, CAH= chronic active hepatitis; NANBH =non -A, non-B hepatitis; NHT FVI I I= non -heat-treated factor Vlll *indeterminate RI BA and I nnogenetics LIA. P=posrtme, N= negative, I= indeterminate.

second-generation

assays;

however, 8 (38%) of the 21 first-

generation anti-HCV negative samples were positive on retesting. Confirmatory tests (Ortho recombinant immunoblot [RIBA], Innogenetics [line immunoassay, LIA]) on these 8 samples showed 3 to be indeterminate and 5 positive with the RIBA and 1 to be indeterminate and 7 positive with the LIA, 1 specimen being indeterminate in both tests (table). All 8 samples did not react with 5-1-1, C-100 (RIBA) and 7 did not react with NS4 (LIA) and so would be classified as HCV type 2 and 3 infections by Wan Chan et al. All samples reacted with core antigen bands in both tests. 4 of these patients had clinical or biopsy-proven chronic liver disease and 7 had received non-heat-treated factor VIII. Our results confirm the need to retest all patients with haemophilia with a second-generation test so that the prevalence and clinical relevance of this infection can be studied more accurately in this group.

We thank Dr E. 0. Caul (Bristol Public Health Laboratory Service) for anti-HCV confirmatory work. M.

JEAN GOODRICK

South Western Regional Transfusion Centre, Bristol BS10 5ND, UK

NICOLA A. B. ANDERSON IAN D. FRASER ANDREW ROUSE

G. KUDESIA S. CHAPMAN

Department of Public Health Medicine, Bristol and District Health Authority

Regional Haemophilia Centre, Royal Hallamshire Hospital, Sheffield

M. MAKRIS F. E. PRESTON

Department of Public Health Medicine,

SIR,-Dr MacLennan and colleagues (Jan 11, p 131) report a 46% frequency of intravenous drug use (IVDU) in their

both Ortho

19772 but 9 donors in our survey failed to exclude themselves on that criterion. Furthermore, there is a growing body of opinion that suggests that there should be no time limit on exclusion for those with a history of parenteral drug misuse, and our findings support that view. That 15 people were donating blood, having passed through the routine self-exclusion process, suggests that current procedures are inadequate or not properly enforced and that other high-risk blood donors might be being accepted also. The policy of self-exclusion needs to be re-evaluated and should extend to include anyone who has ever misused parenteral drugs.

Public Health Laboratory, Northern General Hospital, Sheffield S5 7AU, UK

History of previous drug misuse in HCV-positive blood donors

m

VIRGINIA PEARSON

Exeter

Department of Health. Guidelines for the blood transfusion services in the United Kingdom. London: Department of Health, 1989. 2. Department of Health Central Office of Information. AIDS leaflet (NBTS 1181B). June, 1990. 1.

Overexpression of p53 gene in head-and-neck cancer, linked with heavy smoking and drinking

preliminary investigation of the hepatitis C virus (HCV) seropositive donors in north London. In the south-west region of England in the first two months of testing, 31 936 donations were screened for antibodies to HCV (UBI-ELISA), confirmatory testing by radioimmunoblot assay (RIBA-2) being done at the Public Health Laboratory Service’s Bristol Laboratory. Donors whose samples were confirmed positive (25) or indeterminate positive (10) were contacted by letter and a counselling interview was arranged. The interviews were done in confidence. The carefully prepared questionnaire included the question "Have you ever injected substances under your skin or in a vein?". If the answer was "yes", the donor was then asked how long ago that was and

strong association between both p53 mutations and overexpression has been demonstrated in smoking-related lung cancers.4,5 We have investigated p53 expression in head-and-neck squamous cell carcinomas immunohistochemically, using the PAb 420 and 1801 antibodies.6 Since the normal p53 protein has a half-life of only 6-20

whether a shared needle had been used. Of the first 26 donors interviewed 8 were indeterminate positive (4 males) and 18 were confirmed positive (14 males). 15 of the 26 admitted to parenteral drug misuse (58%), 14 of these being confmmed positive by RIBA-2 (12 males); 1 female was indeterminate positive, with antibodies to C-22 on RIBA 2. All 15 had shared needles. 9 of the 15 (60%) admitted IVDU within the

may be inferred that detection of the p53 protein is synonymous with mutation, since the mutant form has a half-life of up to 6-8 h. We have found a correlation between smoking history and positive p53 staining. Six out of seven non-smokers with head-and-neck cancer did not express p53 whereas 29 of 37 heavy smokers had increased p53 expression.6 We have now investigated the relation between p53 expression and a history of smoking and

14 years. These findings are disturbing. The foundation of the UK national policy for ensuring safety of blood supplies has been self-exclusion of donors in high-risk groups/ However, specific questioning about IVDU has been limited to that advised in a leaflet prepared for donors by the Department of Health; the current version (June, 1990) excludes those who have injected drugs since

drinking. 48 patients with squamous cell carcinoma of the head and neck were classified as non-smoker, moderate smoker ( < 20 cigarettes per day), or heavy smoker and as non-drinker, moderate drinker

previous

SiR,—Mutations in the p53 gene are proving to be one of the genetic changes in human cancer.1,2 Normal levels of p53 act as tumour suppressor genes, but mutations in the p53 gene commonest

can convert

it into

a

dominant and no

longer suppressive gene.3 A

min, it

( < 21 units per week), or heavy drinker. No correlation was found between p53 expression and any clinicopathological features. We used weighted logistic regression analysis to look for a relation

History of previous drug misuse in HCV-positive blood donors.

502 CLIN I CAL AND LABORATORY FINDINGS ON 8 SAMPLES FROM ANTI-C-100 NEGATIVE HAEMO PHI LIACS CPH= chronic persistent hepatitis, CAH= chronic active...
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