SUMMARY.All blood donors in Scotland who were found to be infected with hepatitis C virus (HCV) in the first 6 months of routine testing of all donations for anti‐HCV were contacted. Those who attended were counselled, a history of exposure to risk was sought, and blood was taken for alanine aminotransferase (ALT) level as a measure of liver function. The epidemiological features were then correlated with the virological findings and ALT.In the period under study between September 1991 and February 1992, 180658 blood donors attended. The prevalence of HCV infection was 0.088. Of the 151 donors who attended for counselling, 101 (68) were male. Intravenous drug use was the most common risk activity (39), followed by previous blood transfusion (15.2), other parenteral exposure (11.2) and heterosexual contact with a parenterally infected partner (8.6); 29.1 of donors gave no history of possible exposure.Elevated ALT levels were found in 59. ALT levels were higher in donors with HCV types 1 and 3 than in HCV type 2 or non‐viraemic donors.The prevalence of HCV in Scottish blood donors is thus relatively low. This may relate to the effectiveness of donor selection procedures, but donors with risk activities which should debar them continue to donate. The combination of ALT and PCR appears to be useful in counselling and assessing infected don
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