Markers In Blood Donors Research Articles

Seroprevalence of HIV, Hepatitis B and C Viruses, and Treponema Pallidum among Blood Donors Attending the Garoua Regional Hospital Blood Bank, North Cameroon, a Cross-Sectional Study

Background. Human immunodeficiency virus (HIV), hepatitis B (HBV), and hepatitis C virus (HCV) are transfusion-transmittable infections (TTI). They currently constitute a major public health problem in Cameroon, like in other developing countries. Little is known about the seroprevalence of HIV, HBV, HCV, and syphilis among blood donors in northern region Cameroun. This study aims at filling the gap on the unknown sero-prevalence of those markers in blood donors. Methods. We conducted a cross-sectional study from June 04, to July 08, 2022 at the Garoua Regional Hospital Blood Bank (GRHBB). A total of 201donors were consecutively included and data on donor’s sociodemographic characteristics were obtained by the national program’s questionnaire. Serum samples from blood donors were tested using sensitive third generation Rapid diagnostic test (RDT) for presence of Hepatits B surface antigens (HBsAg), and antibodies to human immunodeficiency (HIV-1/2), Hepatits C (HCV) and Treponema pallidum; and quantitative enzyme-linked immunosorbent assays (ELISA) served for confirmation. Data were collected and entered into an Excel sheet and then exported to SPSS version 20.0 for analysis. Results. A total of 201 blood donors were identified and the sex ratio (male/female) was 7/1, with a mean age of 32.12 ± 8.4 years (range: 19 to 57 years). Of all blood donors, 35/201 (17.4%) were infested by at least one of the four TTIs. Among blood donors, HIV, HBV, HCV and syphilis were 5 (2.5%); 26 (12.9%); 1 (0.5%) and 5 (2.5%), respectively. Co-infection with HIV-Syphilis was 1 (0.5%); and HBV-HCV 1 (0.5%). Conclusions. This study has revealed the high prevalence of TTIs in blood donors who attended the Garoua Regional Hospital Blood Bank, identifying Hepatitis B as the greatest threat to blood safety in the North Region of Cameroon.

Infectious Markers in Blood Donors at the Fixed Blood Collection of the Yamoussoukro Blood Transfusion Center in Côte D’ivoire

Introduction: Despite the progress made in blood safety, blood transfusion-related infections remain a concern in view of these national statistics. Aim of the Study: To determine the seroprevalence of infectious markers transmissible by blood transfusion in blood donors at the Yamoussoukro Blood Transfusion Center. Method: This is a retrospective study that took place at the Yamoussoukro Blood Transfusion Center. The data were collected from all old and new blood donors deemed suitable for the fixed collection of the year 2020. ELISA tests were used to screen for HIV antibody, HBsAg and HCV antibody; syphilis screening was done using the VDRL (Venereal Disease Research Laboratory) test. Results: All 1160 blood donors of the fixed blood collection in 2020, no positive results for the different blood-borne diseases were recorded. On the other hand, one doubtful result and two unperformed tests were observed for each infectious marker. Conclusions: The seroprevalence of infectious markers in blood donors is very low in fixed collection at the Yamoussoukro Transfusion Center

Frequency of hepatitis and HIV co-infection markers in blood donors at the Hospital Professor Bocar Sidy Sall of Kati-Mali

The transmission of infectious agents such as human immunodeficiency virus (HIV), hepatitis B (HBV), and hepatitis C (HCV) represents the greatest threat to the safety of blood transfusion to the recipient. The association of HIV infection with HBV and/or HCV is common worldwide, due to shared modes of transmission. The prevalence of HIV-HBV co-infection is estimated to be 5-10% in the United States and 20-30% in Asia and parts of sub-Saharan Africa. Other studies report HCV co-infection in 9-25% of HIV-infected patients. The aim of this study was to determine the frequency of markers of co-infection between hepatitis (B,C) and human immunodeficiency virus in blood donations collected at the CHU Kati blood transfusion center. It was a retrospective study conducted from October 1 to December 31, 2018. Data were collected from blood donors aged 18 to 60 years. The Pre-donation medical interview was the first barrier for the selection of subjects at risk. The sample was composed of 92% males and 8% females out of a total of 507 individuals sampled. Biological screening was performed by ELISA (Enzyme Linked Immuno Sorbent Assay). The results revealed a prevalence of 0.86% of HIV-HBV co-infection only in rhesus negative donors. No co-infection between HIV and HCV was found. This study showed that at the Kati University Hospital, only rhesus-negative donors presented cases of HIV-HBV co-infection.

Frequency of hepatitis and HIV co-infection markers in blood donors at the Hospital Professor Bocar Sidy Sall of Kati-Mali

Frequency of hepatitis and HIV co-infection markers in blood donors at the Hospital Professor Bocar Sidy Sall of Kati-Mali

Prevalence of viral hepatitis B markers among blood donors in the Republic of Guinea

The problem of transfusion safety in relation to parenteral viral hepatitis still remains relevant. Viral hepatitis B (HB) remains the most common viral infection transmitted through transfusion procedures. One of the natural phases of chronic hepatitis B (CHB) is occult hepatitis B infection (OBI), characterized by an undetectable HBsAg (regardless of the other serological markers content) in the presence of hepatitis B virus (HBV) DNA in the liver tissue and an extremely low, up to undetectable, level of viral load in the blood. In the Republic of Guinea, as in most countries on the continent, the prevention of HBV transmission through transfusion is still based on HBsAg serological testing of donors only. In this connection, OBI remains as a potential threat to blood transfusion safety. Detection of HBV DNA is a reliable preventive measure against transmission of the virus from donors with HBsAg-negative HBV infection, especially in highly endemic regions. In this regard, the study was conducted to substantiate recommendations for improving blood safety against the background of significant HBV prevalence in the Republic of Guinea.The aim of the work was the evaluation of serological and molecular markers of HBV infection in blood donors in the Republic of Guinea. We examined 250 blood samples obtained from donors living in Conakry, Republic of Guinea. Samples were tested for the presence of serological (surface antigen, HBsAg; antibodies (ABs) to surface (anti-HBs IgG) and core (anti-HBc IgG) antigens) and molecular (DNA) markers of HBV infection. The overall detection rate of hepatitis B markers was 83.2%; HBsAg was detected in 16.4% of all individuals. The high incidence of HBsAg in men (19.55%) compared to women (8.45%) was shown, the relative risk of HBV infection with the formation of HBsAg-positive chronic hepatitis B in males was also significantly higher. The prevalence of the HBV DNA in the study group was 30.4%, the OBI cases accounted for 15.6%. The prevalence of this form of the disease was shown in donors aged 30-49 years (24.78%), in the group of people younger than 30 years, the incidence was lower (8.73%), and at the age of over 50 years, OBI was not detected. Based on the phylogenetic analysis of 76 virus isolates, it was shown that genotype E prevails in the examined group (85.53%).Cases of pathogen DNA detection occurred in HBsAg-negative blood donors in the presence of anti-HBs IgG (n = 4), as well as in the simultaneous presence of ABs anti-HBs IgG and anti-HBc IgG (n = 7). The viral load exceeded 200 IU/ml in OBI samples. Escape mutations were detected by sequencing in each OBI sample, contributing to the virus escaping from diagnostic based on screening for HBsAg. Assessment of the prevalence viral hepatitis B markers in blood donors, determination of genotypes and clinically significant mutations of virus variants are necessary to ensure safe medical manipulations, control and prevention of the spread of this infectious agent.

Study of Seroprevalence of Hepatites “B” and “C” Markers in Blood Donors from Hemonorte, Rio Grande Do Norte/ Brazil

Viral hepatitis transmissible by blood more frequent in the Brazilian population are those of type B and C. Blood banks and hemotherapy centers (Hemocenters) must carry out serological screening, in order to statistically evaluate the percentage of infected donors the virus of these hepatitis. This study aimed to characterize the blood donor population of the State of Rio Grande do Norte (RN), located in the Northeast region of Brazil, in relation to serological markers of hepatitis B and C and to compare these donors from different regions of RN. Were performed serological tests from 254.332 blood donations at the Laboratory of Serology of Hemocenters of Rio Grande do Norte (HEMONORTE) by indirect ELISA methodology. The state of RN was divided into three regions according to the presence of transfusion units or Hemocenters in: Natal city, capital of the state of RN and nearby cities and also headquarters of HEMONORTE; Western Region comprising the Hemocenter of Mossoró city and and transfusion unit of Pau dos Ferros city; and the Serido region of the hemocenter of Caicó city and the collection and transfusion unit of the Currais Novos city. The markers used for hepatitis B detection were total anti HBc (IgM and IgG) and HBsAg. The research of the virus Hepatite C virus carried out with those with third generation kits containing core proteins NS3 and NS4, in addition to NS5. The samples were considered reactive (seropositive) when optical density was obtained up to 20% below the cut-off value, which is the criterion used by most blood centers in Brazil. Among the various serological markers of hepatitis B and C, anti-HBc was the most prevalent with a percentage of 0.98%. Anti-HCV presented a prevalence of 0.77%, while HBsAg had a low prevalence (0.07%). When comparing the prevalence by region, we found that the Natal city region had the lowest rates of hepatitis B (0.93%) and hepatitis C (0.71%). The western region presented the highest percentages of reactivity for hepatitis B (1.24%) and C (1.16%). The seridó region of obtained a prevalence of hepatitis markers smaller than the western region and larger than that of the , 0.99% for hepatitis B and 0.91% for hepatitis C. This difference of percentages between regions should be investigated , to find out the reason for this prevalence variation. The strategy of clinical recruitment and screening should be reassessed and unified among hemotherapy services in Rio Grande do Norte. Disclosures No relevant conflicts of interest to declare.

Seroprevalence of Infectious Markers in Blood Donors in Mbujimayi “Case of Kansele General Hospital” (Democratic Republic of Congo)

Blood transfusion is a life-saving act because in some cases, it is the last resort to save an individual’s life. However, the seroprevalence of infectious markers in blood donors is a major public health problem, both in developed and developing countries, in its magnitude. The purpose of this study was to determine the seroprevalence of infectious markers in blood donors. This is a descriptive study conducted in the city of Mbujimayi at kansele Hospital among registered blood donors (family volunteers and paid) from the period 12/01/2017 to 13/01/2018. The data were collected in a cross-sectional manner. The following observations were made: in the study period, 522 blood donors were registered. After analyzing the data, the seroprevalence of HIV/AIDS in blood donors is 4.4%, 2.1% of cases have an HCV serological status and 5.9% a HBS positive serological status, and 2.1% a positive RPR HIV status, the male sex predominated with 85.4% was male.

Prevalence of Hepatitis B and C Viral Markers in Blood Donors Deferred from Donating Blood on the Basis of a History of Jaundice of Unknown Origin

The aim of the present study was to know the prevalence of viral hepatitis markers among blood donors deferred on the basis of a history of jaundice of unknown origin and to predict the impact of this deferral on blood safety. Observational study included 200 blood donors deferred on the basis of a history of jaundice of unknown origin and carried out serology and Individual Donation Nucleic Acid Testing (ID-NAT) for hepatitis B and hepatitis C. Five (2.5%) out of 200 blood donors deferred on the basis of history of jaundice were reactive on ELISA. Three out of five were reactive for HBsAg; whereas two for anti-HCV antibodies. Out of the 12 ID-NAT initial reactive, 10 samples discriminated on further testing; 4 for HBV, 5 for HCV and 1 was co-infection (HBV+HCV). The odds of being picked up as sero reactive on ELISA was 2.53 (95% CI; 1.04-6.19) and being picked up as ID-NAT yield was 13.08 (95% CI; 5.29-32.37) in donors deferred on a history of jaundice of unknown origin as compared to selected donors without a history of jaundice, with the difference in means achieving statistically significance at P=0.03 and <0.001 respectively.The potential of deferral on a history of jaundice of unknown origin has a capacity to interdict 2-3 HBV and/or HCV reactive blood donors on serology and 5 HBV and/or HCV reactive blood donors on ID-NAT from entering the quarantine blood supply per 100 donors. The findings of the present study support that a deferral for a history of jaundice of unknown origin after attaining the age of 12 years in the present scenario of transfusion transmissible infectious disease screening in India.

Trends of blood-borne infectious diseases in a rural blood donation center of southeast Gabon (Koula-Moutou).

IntroductionBlood-borne pathogens such as human immunodeficiency virus (HIV), hepatitis B and C (HBV and HCV) viruses and Treponema pallidum remain a major public health problem in sub-Saharan Africa. The purpose of this study was to assess the frequency and clinical implications of HIV, HBV, HCV and Treponema pallidum markers in blood donors in a rural area of Southeast Gabon (Koula-Moutou) from 2012 to 2017.MethodsHepatitis B surface antigen (HBsAg), anti-HIV, anti-HCV and anti-Treponema pallidum antibodies were screened using rapid diagnostic tests (RDTs).ResultsOf a total of 5,706 blood donors, 1,054 (18.5%) were seropositive for at least one infectious marker and 59 (5.6%) had serologic evidence of multiple infections. The overall seroprevalence of HIV, HBsAg, HCV, and syphilis was 3.1%; 5.9%; 6.2% and 3.3%, respectively. HIV, syphilis and HCV distributions were associated with neither the sex nor the age of the donors. Only HBsAg seroprevalence was significantly higher in donors of the age group 26-35 years old compared to donors of the age group 36-45 years (OR = 1.43 (95% CI: 1.01-2.04), P = 0.045). There was a significant increase in the frequencies of HIV and syphilis and a regression of HBsAg and HCV among blood donors.ConclusionThis study presents the epidemiology of the main pathogens detected in blood donors in a rural area in Gabon. We found that the overall distribution of transfusion transmitted infectious diseases were lower than those observed in the general population but could be underestimated due to the use of RDTs in the screening process of the blood donations.

Distribution of serological screening markers at a large hematology and hemotherapy center in Minas Gerais, Southeastern Brazil.

ObjectiveTo assess the distribution of serological markers in blood donors at the blood banks of the Fundação Centro de Hematologia e Hemoterapia de Minas Gerais (Hemominas), Brazil, between January 2006 and December 2012.MethodsThis is a descriptive, retrospective study on blood donors screened using serological tests for markers of transmitted diseases at the state blood-banking network.ResultsApproximately 78.9% of the donors were considered eligible for the study after clinical screening. Repeat donors represented 68.2% of the total sample, with males being predominant as blood donors (66.8%). Total serological ineligibility was 3.05%, with total anti-HBc being the most common marker (1.26%), followed by syphilis (0.88%) and human immunodeficiency virus (0.36%). The prevalences of the markers for hepatitis C, Human T-cell lymphotropic virus, Chagas disease and HBs-Ag were 0.15%, 0.09%, 0.13% and 0.18%, respectively. The blood bank of Governador Valadares had the highest percentage of positive anti-HBc donors (2.41%). With regard to human immunodeficiency virus, the blood bank of Além Paraíba had the lowest percentage of positive donors while the blood banks of Juiz de Fora and Betim had the highest percentages. The blood bank in the city of Montes Claros had the highest prevalence of the marker for Chagas disease (0.69%).ConclusionsData on the profile of serological ineligibility by the blood banks of the Fundação Hemominas highlights the particularities of each region thereby contributing to measures for health surveillance and helping the blood donation network in its donor selection procedures aimed at improving blood transfusion safety.

Prevalence of Serologic Hepatitis B Markers in Blood Donors From Puebla, Mexico: The Association of Relatively High Levels of Anti-Core Antibodies With the Detection of Surface Antigen and Genomic DNA.

BackgroundThe hepatitis B virus (HBV) causes chronic hepatitis, hepatic cirrhosis, and hepatocellular carcinoma. Surface antigen (HBsAg) detection is a definitive test that can confirm HBV infection, while the presence of antibodies against the core protein (anti-HBc) suggests either a previous or ongoing infection or occult hepatitis B infection (OBI).ObjectivesThe aim of the present study was to determine the prevalence of anti-HBc and HBsAg in blood donors. Further, the study aimed to estimate the anti-HBc level at which HBV DNA is detected in putative OBI cases, as well as to search for mutations in the “a” determinant associated with the non-detection of HBsAg in serum.Patients and MethodsWe conducted a cross-sectional study from 2003–2009. The study included 120,552 blood donors from the state of Puebla, Mexico. Different commercial systems based on microparticles (enzymatic (MEIA) or chemiluminescent (CMIA)) were used to determine the HBsAg and anti-HBc levels. For the detection of HBV DNA, a nested polymerase chain reaction (nested PCR) was used and the genotypes were determined using Sanger sequencing.ResultsOf the 120,552 blood donors, 1437 (1.19%, 95% CI: 1.12 - 1.26) were reactive to anti-HBc, while 82 (0.066%, 95% CI: 0.053 - 0.079) were reactive to HBsAg. Some 156 plasma samples collected in 2009 from anti-HBc-positive/HBsAg-negative blood donors were submitted for HBV DNA detection in a search for probable OBI. Viral DNA was detected in 27/156 (17.3%, 95% CI: 11.5 - 23.1). Our results show an association between HBV DNA or HBsAg and anti-HBc S/CO levels ≥ 4.0. All DNA samples were identified as genotype H and some “a” determinant mutations were identified, although none corresponded to mutations previously reported to hinder the detection of HBsAg by commercial immunoassays.ConclusionsWe observed that as the anti-HBc levels increase, there is a higher prevalence of the viral protein HBsAg in blood donors. Samples testing positive for HBV-DNA were seen to exhibit a ten-fold higher presence of anti-HBc S/CO ≥ 4 than those with S/CO ≥ 1 and < 4.0, which highlights the relevance of anti-HBc determination in blood donor samples.

Sero-prevalence of Transfusion Transmissible Infections Markers Among Blood Donors Attending the Blood Transfusion Department Of A Teaching Hospital in Chittagong

As per Safe Blood Transfusion Law 2002 of Bangladesh and worldwide strategy of screening of Transfusion Transmissible Infections (TTIs) markers in blood donors of various categories is a must for the prevention of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS), Hepatitis B virus (HBV), Hepatitis C virus (HCV), Syphilis and Malaria with a aim to decrease morbidity and mortality of the patients receiving blood and blood components. A total of 33,553 blood donors attending the Blood Transfusion Department of Chittagong Medical College Hospital from January 2009 to December 2009 amongst which replacement or relative donors were 30868 (92%), voluntary donors 2685 (8%) and male donors 27722 (82.62%), female donors 5831 (17.38%). Among the donors 15133 (45.10%), were of age group between 18-25 years, 17809 (53.08%) were of age group between 26-45 years, and 611 (1.82%) were of age group between 46-60 years. The purpose of this study was to determine the sero-prevalence of HIV, HBV, HCV, Syphilis and Malaria in blood donors in a Teaching Hospital at Chittagong, Bangladesh. Blood samples from selected donors were tested for HIV, HBV HCV and Malaria by Immunochromatographic (ICT) rapid test device, Syphilis by rapid plasma reagin (RPR) test device method. Screening procedures were in accordance with the manufacturer’s instruction in terms of adding serum, adding buffer and time duration of reading results. Screening result after compilation shows HIV was reactive in 7 (0.02%) donors all of which were male. HBV was reactive in 285 (0.849%) donors, out of which 272 (95.43%) were male and 13 (4.57%) were female. HCV was reactive in 23 (0.068%) donors, out of which 18 (78.24%) was male and 5 (21.76%) were female. Syphilis was reactive in 32 (0.095%) donors, out of which 29 (90.62%) was male and 3 (9.38%) were female. Malaria was reactive in 31(0.09%) donors all of which were male. By studing this prevalence, attention will be drawn towards severity of the situation so that effective measure can be taken to prevent further transmission of TTIs by blood transfusion. DOI: http://dx.doi.org/10.3329/bmj.v40i3.18673 Bangladesh Medical Journal 2011 Vol.40(3):37-39

Factors for viral infection in blood donors of South Kivu in the Democratic Republic of Congo

IntroductionAssessing the knowledge, attitudes, practices and behaviors among blood donors in South Kivu and identify risk factors for viral markers.MethodsA descriptive and analytical cross-sectional study involved 595 blood donors in the city of Bukavu (Head city of the province of South Kivu) in the eastern Democratic Republic of Congo.ResultsOur sample consisted of 70.3% men with a median age of 23 and 77% of young people fewer than 30 years. The score of knowledge and attitude of blood donor's volunteer on blood safety were assessed at 23.5% and 79.1%. A statistically significant difference was observed between the loyal and new blood donors volunteer (25.1% vs 64.6% p < 0.001); between blood donors volunteer of low and high education level (p = 0.04). Motivation to donate blood in 95.9% of cases respect ethical rules of donation. The prevalence of viral markers in blood donors is as follows: 4.8% hepatitis B, 3.9% hepatitis C, 1.6% HIV. For HIV, the low level of education and replacement blood donors are most at risk, the antigen of hepatitis B is observed in blood donors over 30 years, blood donors living couple.ConclusionGeneral knowledge on blood safety is very low in the first link in the chain transfusion (blood donors). A good education of this population conducted by the transfusion service reinforced building (training and support) is needed.

Comment on: Blood discard rate and the prevalence of infectious and contagious diseases in blood donors from provincial towns of the state of Paraná, Brazil

were: anti-HBc (1.03%), HBsAg (0.07%), syphilis (0.35%), anti-HCV (0.04%), human immunodeficiency virus (HIV - 0.02%) and Chagas disease (0.02%). No positivity occurred in this study with respect to human T-lymphotropic virus (HTLV) I/II markers. A study conducted by Salles et al. in 2001 showed that the prevalence of infectious diseases among donors was: 0.04% for HIV, 0.21% for hepatitis C virus (HCV), 0.06% for HTLV, 0.14% for Chagas’ disease, and 1.10% for syphilis. For hepatitis B virus, the prevalences found were 0.14% for anti-HBc and HBsAg, 1.68% for anti-HBc and anti-HBs, and 1.67% for anti-HBc in isolation (3) . As new technologies are developed, the discovery of new infectious agents and the reemergence of old threats are an ongoing challenge in blood banks. I believe that similar studies should be encouraged in order to reinforce the importance of characterizing the prevalence of these serological markers in the blood donor population. In conclusion, this study is of great scientific relevance and reinforces the importance in establishing the prevalence of serological markers in blood donors. These results increase the knowledge about the role of the educational measures that have been carried out and may support the structuring of new awareness-raising campaigns for spontaneous blood donation.

Investigation of age, gender and MBL deficiency in relation to inflammatory markers in blood donors

Aim Markers of inflammation in the blood of donors were interrogated with reference to mannose-binding lectin (MBL) level, donor age and gender. Methods Inflammatory markers determined in 426 donors (253 male, 173 female; age 17-76, stratified for analysis 17-25 n = 88, 26 –40 n = 121, 41-60 n = 171, 61-76 n = 45) were: IL-6, IL-8, IL-10, IL-12, IL-1a, IL-1(3, TNF-a, IFN-a, IFN-y, MIP-1a, MCP-1 (CBA, BD Biosciences), C-reactive protein (CRP) and rheumatoid factor (RF) (immunoturbidimetry, Roche). Functional MBL level was determined by ELISA (deficiency Results Plasma levels of all inflammatory markers plasma levels were within normal published ranges. MBL level declined with age ( p p p p p p Conclusion Age was the predominant factor associated with the inflammatory profile in donors; given the aging Australian population, understanding changes in blood components dependant on donor age is an emerging concern.

Evaluation of blood supply operation and infectious disease markers in blood donors during the Egyptian revolution

The Egyptian revolution took place on January 25, 2011. Millions of protesters demanded the overthrow of the Egyptian president's regime. Many people suffered from life-threatening injuries after violent clashes between police and protesters. The overall management of the blood bank operation at Cairo University Hospital was described, in an attempt to evaluate blood safety and establish a standard effective plan to manage blood supply during crisis. Three days after the uprising, thousands of Egyptians rushed to the hospital to alleviate the blood shortage. A total of 3425 units were collected in 3 days and thousands of donors were turned away. An error delayed processing of 1000 units and they were used as stored whole blood. Apheresis platelets were donated by protesters who were particularly motivated to donate for two victims with liver injury. The usual positive rate of hepatitis C virus (HCV) antibody in Egyptian donors is 3.8%. However, the positive rate of HCV markers in the collected units was only 1.6%. The mean age of donors during the revolution was 31.7±10.4 years while the usual mean age of donors is 39.2±8.5 years. Operating theaters were used only for emergencies. A blood surplus developed that met the hospital needs for 1 month. Revolution resulted in an influx of first-time donors with a relatively low positive rate of HCV antibody. To be prepared for disasters, a systematic approach to spread donors evenly on a daily basis is needed.

Infectious disease markers in blood donors at central referral hospital, Gangtok, Sikkim

Sir, A safe blood is a critical component in improving health care and in preventing the spread of infectious diseases globally. Yet the quality and safety of blood transfusion is still a concern for a health-care personnel. The extent of infectious disease markers of major blood-borne pathogens [hepatitis B (HBV), hepatitis C (HCV), human immunodeficiency virus (HIV), syphilis and malarial parasite] was observed as with age and sex distribution for the donor population of the blood bank of a tertiary care hospital of Gangtok during 2001-2008. Of the 3735 donors, 2423 (64.87%) were replacement and 1312 (35.13%) voluntary donors; male donors were 3434 (91.94%) and females were 301 (8.06%) with overall seroprevalence of major blood-borne pathogens (HIV, HBV, HCV and Syphilis) was 1.63%. The sero-positivity of HIV, HBsAg, anti- HCV, and syphilis was 0.32, 0.78, 0.27 and 0.27%, respectively. Unlike other studies,[1,2] which showed a lower prevalence of HIV, HBsAg, and anti-HCV in voluntary donors, we observed a higher HIV, HBsAg, and anti-HCV sero- positivity in voluntary donors as compared to replacement donors, though the difference in prevalence in these two groups was not statistically significant [Chi-square test (with Yates correction) = 0.02974 (P = 0.10); 0.01495; (P = 0.9027); 1.738 (P = 0.1874) respectively]. Whereas syphilis positivity was found to be higher in replacement donors as compared to voluntary donors though not statistically significant [Chi-square test (with Yates correction) = 0.4513 (P = 0.5017)], which was in agreement with other studies.[1,2] HIV and anti-HCV sero-positivity was nil from 2001 to 2005 among our donors. There was no significant change in the prevalence of HIV, HBsAg, HCV, and syphilis positivity over the period (Chi - square for trend = 5.913, P = 0.0120; 0.01728, P = 0.6776; 2.440, P = 0.1183; 0.04003, P = 0.8414, respectively). There was no HIV, HCV and syphilis positive case among female donors in our study population. The HBV positivity was the only infection found in one female donor in our total female donors in the age group of 21-40, which was statistically significant (P = 0.0062). There were no HIV and syphilis positive cases below the age of 21 years. No sample showed malarial parasites. There was not a single case positive for co-infection with two or more infectious agents. Though the screening tests used for these infections were not 100% sensitive or specific,[3,4] and the approximation of the infectious disease markers in our donor population was less, there is no scope of complacency.

Voluntary and not replacement donors are safe!

Dear Editor I read with the interest article ‘Infectious disease markers in blood donors’ published in Jan 2008 issue of MJAFI [1]. The authors reported the data of routinely screened Transfusion Transmitted Infection (TTI) markers from 2003-2005. Similar article by Gupta P et al [2] presented the blood donor screening data for period from 2000-2004 of Department of Transfusion Medicine, Armed Forces Medical College (AFMC) Pune. Screening of blood donors for these TTI markers is statutory requirement vide Drugs and Cosmetics Act 1940 [3]. Further all blood banks are required to submit the data to National AIDS Control Organization (NACO). In addition, blood banks of Armed Forces are required to submit the data to Central Disease Registry/AIDS Control Organization (ACO), Dept of Preventive and Social Medicine, AFMC, Pune. The authors reported 14.3% voluntary blood donation [1]. Voluntary donation of 58.7% and 55.2% in year 2003 and 2004 respectively was reported at AFMC [2]. NACO reported overall voluntary blood donation of 52.2% in 2004 [3]. A study from Kolkata reported voluntary blood donation of 94.6% [4]. Thus voluntary blood donation of 14.3% is abysmally low; against the national short term goal of 80% [3]. The authors reported no difference in prevalence of TTI markers in voluntary and replacement donors (in fact prevalence of infectious markers except HIV was lower in replacement donor than voluntary, though statistically not significant). Based on these findings, authors recommended replacement donation in meeting blood demand in Armed Forces setting [1]. The recommendation is retrograde and against the present national policy of recruitment and retention of voluntary donors [4]. Even data from AFMC in Armed Forces perspective is unambiguous; replacement donors carry more risk of TTI [2]. Further, any such recommendation needs to be based on all India data, in which role of ACO for Armed Forces perspective is of paramount importance. The authors arrived at conclusion of better socioeconomic status of blood donors being the reason for low prevalence of TTI. Will these individuals be more amenable to motivation for voluntary donations? It will be prudent to know the effect of more proactive strategies in improving voluntary blood donations in this group; which will avoid reverting back to replacement donations. The authors found declined trend in prevalence of Hepatitis C virus infection and syphilis; which is encouraging. This also means the time to move on and evaluate newer tests or strategies such as nucleic acid tests, anti HBc assay or leucodepletion in achieving newer heights in safety of transfusion than rejoicing the declining trends of conventional TTI markers. We need to evolve for safety in transfusion!

Infectious disease markers in blood donors

Background: The infectious disease markers for which blood donors are screened include anti-human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg), anti-hepatitis C virus (HCV), rapid plasma reagin (RPR) card test for syphilis and malarial parasites. Methods: A total of 6751 donors were screened over three years to assess the prevalence of infectious disease markers. Screening for anti-HIV I and II, HBsAg and anti-HCV was carried out by enzyme linked immunosorbent assay (ELISA). Syphilis was tested using RPR card test. Malarial parasite was tested by detection of genus specific plasmodium lactate dehydrogenase. Result: The overall seropositivity for anti-HIV I and II was nine (0.13%), for HBsAg 67 (0.99%), for anti-HCV 13 (0.19%) and for syphilis 42 (0.62%). No sample showed malarial parasites. There was no significant difference (p>0.05) in the seropositivity of various markers between voluntary and replacement donors. There was a significant decline (p<0.05) in the prevalence of seropositivity for HCV and syphilis, but not for HIV and HBsAg over the three year period of the study. Conclusion: The prevalence of infectious disease markers was similar to that reported by other studies. However, no significant difference was seen in the marker positivity in voluntary and replacement donors, which is at variance from other studies.

Assessment of Liver Disease and Biochemical and Immunological Markers in Swedish Blood Donors with Isolated GB Virus C/Hepatitis G Virus Viremia

Objective: To investigate signs of liver disease, and biochemical and immunological markers in blood donors with isolated GBV–C/HGV viremia. Methods: Eighteen donors with isolated GBV–C/HGV viremia were followed up 3–5 years after initial identification. Testing for GBV–C/HGV RNA, GBV–C/HGV–E2 antibodies and a range of biochemical and immunological tests was performed. Thirteen donors consented to liver biopsy. Results: Twelve donors remained GBV–C/HGV viremic at follow–up. Five donors had developed E2 antibodies. Liver biopsies revealed mild portal inflammatory lesions in 6/11 individuals with persistent viremia, and steatosis in 10/13 biopsied donors. Conclusion: Steatosis and mild portal inflammatory lesions were found in liver biopsies from several blood donors with isolated GBV–C/HGV viremia.