Hepatitis C virus (HCV) represents a major health problem in Egypt. The screening of blood donors is one method to reduce the spread of HCV. However, there is an emergence of a condition known as occult HCV infection (OCI) which is defined as the presence of HCV-RNA in peripheral mononuclear blood cells (PBMCs). Therefore, the aim of the present study was to study the presence of OCI among blood donors by real time polymerase chain reaction. The study included 100 randomly selected blood donors. The volunteer's blood donors' were subjected to full clinical data history and blood samples were obtained for serological studies of HCV, hepatitis B s antigen (HBsAG) and HIV1/2 antibodies by enzyme linked immnosorbent assay (ELISA) and liver transaminases. Then the presence of HCV-RNA was detected in plasma and PBMCs by real time polymerase chain reaction. The mean age� SD of the studied blood donors was 34.8� 10.1 years they were 69% males and 31% females. The residence of most of them was urban 77%. All blood dobnors wre negative for HIV by ELISA, HCV IgG was positive in 10% of them and HBsAg was present in one blood donor. Isolated HCV-RNA in PBMCs was detected in 5 donors (5%), HCV-RNA was present in plasma of 7 blood donors with positive HCV-IgG. There was significant association between HCV IgG and HCV-RNA in plasma (P=0.0001). Moreover, there was significant increase in alanine aminotransferase in the donors positive for HCV-RNA in PBMCs and in HCV-RNA positive in plasma (55.0� 4.9, 55.0 � 13.4 respectively) compared to negative blood donors (28.0� 10.0), P=0.0001. Also, aspartate aminotransferase had significantly elevated level in the donors positive for HCV-RNA in PBMCs and in HCV-RNA positive in plasma (47.8� 6.6, 47.6 � 14.7, respectively) compared to negative blood donors (24.8� 9.7), P=0.0001. The present study highlights the prevalence of occult hepatitis C virus among blood donors. This pilot study demonstrated the presence of occult hepatitis C associated with elevated liver transaminases enzymes that can be used as a clue for such condition. There is a need for nucleic acid amplification technology in blood banks for complete assurance of blood transfusion safety. There is a need to large population studies for proper determination of occult hepatitis C in Egyptian blood donors.

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