Incidence of Hepatitis B Surface Antigen among Sickle Cell Disease Patients Receiving Transfusion Therapy

Abstract

Sickle cell disease (SCD) patients deserve serious attention regarding their Hepatitis B status because episodes of jaundice in the disease may be misleading in many cases. It may either be part of the chronic haemolysis they experience or due to blood transfusion (supportive therapy) related hepatotropic viral infections (Hepatitis-B). The aim of the study was to determine the incidence of Hepatitis B virus infection due to transfusion therapy among SCD patients. Venous blood samples were taken from 202 consenting SCD patients. Haemoglobin-electrophoresis was done to determine the sickling status and Haemoglobin (Hb) genotype of each patient. The samples were then tested for Hepatitis B Surface antigen (HBsAg) using the immunochromatographic method. A questionnaire correlating Hepatitis-B infection and history of blood transfusion was used to obtain other data from the patients. Out of 202 patients who participated in the study, 87 were males and 115 females. The Hb genotype distributions were as follows: SS (128), SC (66), S-β thal (5), CC (2) and SE (1). 99 out of the 202 had a history of blood transfusion. The frequency of HBsAg in the participants was 3.5% and the relative risk of infection by blood transfusion was 2%. It was found that sickle cell disease patients are not at a major risk of hepatitis B viral infection due to transfusion therapy because of the use of properly screened donor blood. However, there remains a significant risk by donations from infected donors who have not yet developed detectable HBsAg levels.