A Pilot Study of Hepatitis B Viral Markers in Volunteer Blood Donors in Kenya, East Africa

Abstract

The occurrence of three major markers of hepatitis B viral (HBV) infection - the surface antigen (Hb(s)Ag), its specific antibody (HB(s)Ab), and antibody to the core antigen (HB(c)Ab) - is reported on 101 Kenyan volunteer blood donors which are tested by highly sensitive techniques. The surface antigen carrier rate was 14% by radioimmunoassay as opposed to 0.1-1% in Northern Europe and in the USA. The prevalence of the core aad surface antibodies is 53 and 57%, respectively. The core antibody as the only indicator of HBV infection occurred in 3% of Kenyan donors as compared to 0.4 in Caucasian volunteers. The overall infectious pool of HBV in Kenyan donors is 17%. Another application of the core and surface antibody screening of the blood donors has been reported recently in relation to the control of non-A, non-B posttransfusion hepatitis. The coexistence of the two antibodies is observed in 41% of the Kenyan donors after excluding the infectious pool. Exclusion of such a large proportion of donors to control non-A, non-B posttransfusion hepatitis is impractical in Kenya though it can be considered in Europe and in the USA where their prevalence rate is 1-4%. It is relevant to observe, however, that in spite of such high transmission rate of the virus in the community in Kenya, 25% of the adult population have been spared. As the immune status in relation to the HBV of the adult recipients of the blood is likely to be similar to that of the donors, a quarter are susceptible to the virus infection. The susceptible group is of course larger still amongst the paediatric recipients.