Transfusion-transmissible Viral Infections Research Articles

Haemovigilance and Trends of Transfusion Transmissible Viral Infections among Asymptomatic Population at Akatsi South Municipal in Volta Region of Ghana from 2014 to 2019

Background: The use of advance screening tools to prevent Transfusion Transmissible Infections (TTIs), is critical to Sustainable Development Goals (SDG.3.3). This study assessed the implications of using chromatographic Rapid Diagnostic Test (RDTs) kits, and dynamics on TTIs, including Human Immunodeficiency Virus (HIV) among blood donors at the Akatsi South Municipality in the Volta Region of Ghana. Methods: This was a haemovigilance study, designed to retrospectively evaluate secondary data on 2,588 blood donors in Akatsi South District Hospital from 2014 to 2019. The data was collected using data extraction log, quality controlled using double data entry mechanism, and managed electronically using Microsoft Visual Basics and STATA. TTIs’ trends were determined using frequentist and descriptive statistics, and 95% confidence intervals using the Clopper Pearson test. Results: Prevalence of TTIs was 8.0%. The prevalence of HIV as well as HBV and HCV, was 3.8%, 3.2% and 1.0% respectively. For female hosts, the prevalence was 7.4% (HIV), 4.2 % (HBV) and 1.6% (HCV). For Male-host, the rates were 3.1% (HIV), 3.5% (HBV) and 1.0% (HVC). Donors aged 15-19years were most infected at rates of 13.2% (HIV), 4.7% (HBV) and 1.9% (HCV). About 57(2.4%) and 3(1.2%) of 2380 blood donated were TTIs false negatives and false positives respectively. Conclusion: Generally, there was reductive trends in prevalence of named TTIs, including HIV at a rate of 30.3% across the period. However, the rate of new HIV infections was above the regional and national rates, and this has research and policy implications. In addition, the limitation of current screening tool to detect about 2.4% of named TTIs among the screened blood was a potential risk medium for transfusing unsafe blood. A relatively higher sensitive blood transfusion screening method is urgently needed to prevent the transfusion of HIV, HBV and HCV false negative blood in Akatsi Municipal Hospital.

Prevalence of Some Transfusion Transmissible Viral Infections among Blood Donors in Federal Medical Centre, Owerri, Nigeria

Prevalence of Some Transfusion Transmissible Viral Infections among Blood Donors in Federal Medical Centre, Owerri, Nigeria

Seroprevalence of transfusion transmissible viral infections in blood donors of tertiary health care hospital in Karnataka

Backgraound: Blood transfusion and its components are significant in saving millions of lives around the worldwide every year. Few, but serious complications are associated with Blood transfusion such as exposure to transfusion -transmissible infections (TTI), in particular: Human immunodeficiency virus(HIV)Hepatitis B Virus(HBV), Hepatitis C virus (HCV). Therefore, methodical pre transfusion testing of blood units for transfusion transmissible diseases is compulsory as per National Aids Control Organization (NACO) guidelines. Objective: To evaluate the prevalence of transfusion transmissible viral infections among blood donors in our tertiary health care hospital in Bangalore, Karnataka. Materials and Methods: The study comprised of retrospective analysis of blood donor’s records covering from January 2015 to December 2018 (4 years) in the department of Blood bank, Sanjay Gandhi institute of trauma and orthopedics, Bangalore. Results: A total of 8728 blood donors were screened for TTIs between 2015 to 2018. Conclusion: Although there were a smaller number of transfusion transmissible viral infection among blood donors, methodical and comprehensive screening of donor’s blood for HIV, HBV and HCV using standard methods are essential to ensure the safety of blood to the recipients. Keywords: Sero prevalence, Transfusion transmitted infections, Blood donors.

Seroprevalence of transfusion transmissible infections among sickle cell anemia patients in Jos, North Central Nigeria

Aims: This study was aimed at determining the seroprevalence of some common transfusion transmissible viral infections in sickle cell anemia patients attending our adult hematology clinic for qualitative management. Methods: A total of 111 sickle cell anemia patients attending the Hematology Outpatient Clinic (HOPC) of the Jos University Teaching Hospital (JUTH) in steady state were enrolled consecutively in this cross-sectional study irrespective of their blood transfusion status. Relevant demographic information and clinical histories were obtained using a structured questionnaire after obtaining informed consent from the subjects. Ethical approval was also obtained from the Institutions Human Research Ethics Committee. Blood sample was collected for complete blood count using a 3-part Sysmex hematology autoanalyzer, confirmatory hemoglobin electrophoresis and viral antigen/antibody screening using ELISA kits. Data was analyzed using Epi Info version 7.2.0.1 and Microsoft Office Excel version 2010. Results: Majority of our subjects were within the age range of 18–30 years, 48 (43.2%) males and 63 (56.8%) females. Seventy-six (68.5%) had blood transfusion while 35 (31.5%) never had blood transfusion in their life. Seroprevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) among the transfused sickle cell anemia patients in this study was 7.9% for HIV, 22.4% for HBV, and 15.8% for HCV while those not transfused had seroprevalence of 8.6% for HIV and 11.4% for both HBV and HCV, respectively. No statistically significant difference was observed between those transfused and those who have not had blood transfusion in their life. Conclusion: Seroprevalence of transfusion transmissible viral infections was relatively high and blood transfusion did not significantly influence the rate of these viral infections in our sickle cell anemia patients. Improved blood screening techniques, provision of antiviral medications, and vaccines at affordable cost are advocated.

Seroprevalence of transfusion transmissible viral infections (HIV, HBV and HCV) among voluntary blood donors at University of Gondar Comprehensive Specialized Hospital, Gondar; Northwest Ethiopia

BackgroundHuman immunodeficiency virus, hepatitis B virus and hepatitis C virus are among the greatest threats to blood safety for the recipient. They are also the leading cause of death, chronic and life-threatening abnormalities. Therefore, this study was aimed to assess the Sero-prevalence of HIV, Hepatitis B and C virus among blood donors at the University of Gondar Comprehensive Specialized Hospital.MethodsA retrospective cross-sectional study was used to estimate the seroprevalence of HIV, Hepatitis B and C virus among blood donors at the University of Gondar Comprehensive Specialized Hospital from May–July 2018. Screening of HIV, HBV, and HCV was done by using the Enzyme-Linked ImmunoSorbent Assay. Records of 5983 first time blood donors were collected and reviewed by using a checklist from registration book. Data was entered in statistical package EP Info version 3.5.1, and data cleaned and analyzed using the statistical package SPSS version 16.0.ResultsOf 5983 blood donors, 85.5% (5118/5983) donors were males and 14.5% (865/5983) were females. The median age was 27 years and the highest blood donations age category was between 20 to 51.2% (29/5983) followed by 30 to 39 years of age, 21.6% (1295/5983). The prevalence of HIV, HBV and HCV infections were 2.5% (95% CI: 1.07–2.398), 4.1% (95% CI: 0.461–1.053) and 1.6% (95% CI: 0.845–3.354), respectively. HIV infection was significantly associated with gender (p = 0.021, x2 = 5.358) and HCV infection with age group (p = 0.003, x2 = 17.673). Of all donated blood, 8.2% (489/5983) had serological evidence for at least one of the screened pathogens and 58 (0.96%) of them had multiple infections.ConclusionsThis study showed a significant prevalence of HIV, HBV, and HCV among blood donors, 2.5% (147/5983), 4.1% (244/5983) and 1.6% (98/5983), respectively. Therefore, strict selection of blood donors with an emphasis on getting voluntary blood donors, and highly sensitive and specific tests for screening of blood donors for HIV, HBV, and HCV using standard methods are highly recommended to ensure the safety of blood for the recipient.

ASSESSING NUCLEIC ACID TESTING VERSUS ELIZA FOR BLOOD VIRUSES DETECTION IN SOME BLOOD BANKS

INTRODUCTION: The goal of any transfusion service is to provide adequate and safe blood and blood products that meet the needs of patients. Transfusion-transmissible viral infections, such as hepatitis C virus (HCV), hepatitis B virus (HBV), and human immunodeficiency virus (HIV), remain a major public health problem in developing countries. Nucleic acid testing (NAT) is a molecular technique for screening blood donations to reduce the risk of transfusion transmitted infections (TTIs) in the recipients, thus providing an additional layer of blood safety. AIM OF THE WORK: To assess the importance of implementing NAT assay to detect donors during window period which are not detected with Enzyme-linked immunoassay (ELISA). SUBJECTS AND METHODS: This cross sectional study was conducted at the Egyptian Abbassia regional Blood Transfusion center (ARBTC) at Abbassia, Cairo. Blood donation collected from 10000 voluntary donors from January 2016 to June 2016 and tested with both ID NAT and ELISA assays for HBV, HCV and HIV. RESULTS: NAT testing has the potential to detect viral nucleic acids of HIV 1-2, HBV, and HCV earlier than current screening methods. CONCLUSION: The implementation of NAT screening for three viruses has improved blood safety and reduced transfusion-transmitted infections.

Prevalence and Trends of HIV and Syphilis Among Blood Donors in the Northern Region of Ghana; A Five-year Retrospective Study

Blood transfusion is considered a life-saver in health care settings, but could potentially pose as a risk factor for transmission of life-threatening viral infections, including HIV, HBsAg, HCV and Syphilis infections. This study was carried out to find out the prevalence and trends of HIV and Syphilis infections among blood donors in the Northern Region of Ghana. Blood screening data of blood donors recorded in blood transfusion centers in the Northern region between 2011 and 2015 were collected and analyzed anonymously. Screening results for HIV and Syphils infections were sorted and analyzed from a total of 198,229 blood donors in the region within the period under consideration. Majority of the donors were female and aged between 20–39 years. The overall seroprevalence rates of HIV and Syphilis were 30.77% (7319) and 27.78% (4893) respectively. The highest seroprevalence was found for HIV followed by Syphilis. These infections were more prevalent in female donors. Highest seroprevalence for both HIV and Syphilis was observed among donors in their youthful ages, i.e. between 20 to 49 years, while Syphilis seroprevalence increased with age. There exists a decreasing trend of transfusion-transmissible viral infections (i.e. HIV and Syphilis) in blood donations. This indicates that the Ghana National Blood Service mandate of ensuring the safety of blood supply has been successful. Even though available statistics show that the prevalence rates of viral infections detected during blood donations has reduced drastically, there is still more to be done, especially using robust and efficient techniques like polymerase chain reaction (PCR). This, the researchers think could guarantee more safety blood for transfusion.

Seroprevalence of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus among hemodialysis patients in a Tertiary Care Teaching Hospital in a developing country.

Background:Human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) prevalence in hemodialysis patients varies geographically, both within and between countries. High prevalence of these infections in dialysis patients reflects the increased presence of common risk factors for their acquisition, including transfusion, transplantation, history of drug abuse, plus susceptibility to nosocomial transmission during dialysis.Objective:The aim of this study is to investigate the seroprevalence and clinical profile of HIV, HBV, and HCV patient's on hemodialysis.Materials and Methods:Clinical and epidemiological data of patients undergoing maintenance hemodialysis in the dialysis unit of a teaching institution were obtained and analyzed over a 5 years' period.Results:A total of 127 males and 69 females were studied. Their mean age was 50.45 years. Out of the total 196 dialysis-dependent patients, 2 (1.02%) were seropositive for HIV antibodies, 6 (3.06%) were hepatitis B surface antigen positive, and 30 (15.30%) were anti-HCV antibody positive. There was no coexistence of HIV, HBV, and HCV markers. The major primary renal diseases in hemodialysis patients included diabetes mellitus (42%), hypertension (22%), chronic nephritis (15%), urologic diseases (6%), cystic renal diseases (4%), and others (11%).Conclusion:Prevalence of transfusion-transmissible viral infections was higher among hemodialysis patients, especially HCV infection which was an alarming situation and therefore strict adherence to infection control strategies, barrier precautions, and preventive measures, including routine hepatitis B vaccination and regular virological follow-up were recommended along with regular education and training programs of technical and nursing personnel's involved with dialysis patients.

Prevalence, pattern and clinical implications of transfusion transmissible viral infections among paediatric haemophiliacs in northern Nigeria

Abstract Background Scarcity of FVIII concentrate compels caregivers in poor countries to use multiple transfusions of fresh whole blood (FWB), fresh frozen plasma and cryoprecipitate for managing haemophilia A. FWB is the most frequently transfused blood product due to ease of production and its ability to simultaneously stop active bleeding and treat anaemia. Iron deficiency anaemia is common among haemophiliacs in poor tropical countries such as Nigeria, due to the combined effects of bleeding, malnutrition, and haemorrhagic parasitic diseases. Multiple FWB transfusion is usually initiated at local sub-tertiary hospitals before eventual referral to tertiary hospitals. The Nigerian blood transfusion service is underdeveloped, donor screening is rudimentary and transfusion safety is poor. The prevalence of transfusion transmissible viral infections (TTVIs), including HIV, and hepatitis B and C viruses (HBV and HCV), is therefore predicted to be high among Nigerian haemophiliacs. Aims To determine prevalence and pattern of TTVIs (HIV, HBV, HCV infections) among paediatric haemophiliacs who have received multiple FWB transfusions in Nigeria. Materials and methods Retrospective analyses of demographic and clinical data, disease severity, number of previous transfusions of FWB, and prevalence and pattern of TTVIs (HIV, HBV and HCV infections) of newly referred haemophiliacs as seen in five tertiary hospitals in northern Nigeria. Prevalence rates of TTVIs were expressed as percentages. Comparisons of parameters (age, disease severity and number of previous transfusions) between patients with and without TTVIs were performed using Students t-test for mean values and Fisher’s exact test for percentages, with p-values of less than 0.05 taken as significant. Results Of 97haemophiliacs studied, 24 (24.7%) were infected with TTVIs. The pattern and frequencies of TTVIs among the infected patients revealed HBV infection in 10 (41.7%), HIV-1 infection in five (20.8%), HCV infection in four (16.7%), HBV and HIV co-infection in three (12.5%), and HBV and HCV co-infection in two (8.3%). In comparison with haemophiliacs without TTVIs, haemophiliacs with TTVIs had a significantly lower mean age (4.9 vs. 7.8; p=0.007); a higher proportion of severe disease (62.5% vs. 26%; p=0.009), and a higher mean number of transfusions per patient (27.5 vs. 15.3; p=0.006). Conclusions The prevalence of TTVIs among haemophiliacs in Nigeria is high, and the risk is correlated with disease severity and number of previous transfusions. There is need for the national transfusion service to be upgraded and for standard haemophilia care centres with an adequate supply of FVIII concentrates for optimal care to be set up. Haemophilia healthcare providers in Nigeria can minimise multiple transfusions by incorporating regular screening and treatment of haemorrhagic parasitic diseases, iron supplementation, and the use of pharmacological agents in the standard of care for haemophilia.

Transfusion Transmissible Viral Infections Risk at Two Teaching Hospitals Blood Banks in Nigeria

Background/ Objectives: Transfusion Transmissible viral infections such as HIV, HBV and HCV are infectious agents that can pose a threat to blood safety. The aim of this study is to determine the prevalence and coinfection of Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) among blood donors tested negative to these viruses by rapid test devices. Materials and Methods: Two hundred and twelve (212) healthy blood donors (108 and 104 from UATH and NAUTH respectively) certified fit for blood donation were recruited for this study. One hundred and nine eighty (198) samples that were seronegative for HBsAg, HIV, HCV and Syphilis by rapid test were examined for the presence of HBsAg, Anti-HCV and HIV (Ab + Ag) using 4TH generation ELISA. Qualitative conventional PCR was used to confirm ELISA positive sera for HBV DNA, HIV RNA and HCV RNA. Results: Out of 198 blood donor samples negative for HBV, HCV and HIV by rapid test, 13.7%, 13.7% and 8.1% were positive by ELISA for HBV, HIV and HCV respectively. Twelve samples (6.1%) have coinfection of TTIs. One (1) sample out of the 12 samples is co-infected with these three viral (HBV, HCV and HIV) agents. Of the 28 samples positive for HBV by ELISA, 20 (71.4%) were positive for HBV DNA, 8 (36.4%) of 22 positive samples by HIV ELISA were positive for HIV RNA and 4 (28.6%) of 14 samples were positive for HCV RNA (p=0.0001). Conclusion and Recommendations: There is a high prevalence of transfusion transmissible viral infections among blood donors at our study population. This study therefore recommends blood donors in these Hospitals in particular and Nigeria in general be screened for HIV, HCV and HBsAg using ELISA 4th generation test kits and Nucleic Acid Testing (NAT).

Transfusion-transmissible viral infections among blood donors at the North Gondar district blood bank, northwest Ethiopia: A three year retrospective study.

BackgroundTransfusion-transmissible viral infections, such as hepatitis C virus (HCV), hepatitis B virus (HBV), and human immunodeficiency virus (HIV), remain a major public health problem in developing countries. The prevalence of these viral infections among blood donors may reflect the burden of these diseases among populations. Therefore, the aim of this study was to assess the sero-prevalence of transfusion-transmissible viral infections among blood donors.MethodsA retrospective study was conducted using data obtained from registration books of blood donors from the Ethiopian North Gondar District Blood Bank from 2010 to 2012. Descriptive statistics, such as percentages, medians and interquartile ranges were computed. A binary logistic regression model was fitted to identify factors associated with each viral infection. The odds ratio with a 99% confidence interval was calculated. A p-value < 0.01 was considered statistically significant.ResultA total of 6,471 blood donors were included in the study. Of these, 5,311 (82.1%) were male, and 382 (5.9%) were voluntary blood donors. Overall, 424 (6.55%) of the blood donors were sero-reactive for at least one transfusion-transmissible viral infection. Of all study participants, 233 (3.6%) were sero-reactive for HBV, 145 (2.24%) were sero-reactive for HIV, and 51 (0.8%) were sero-reactive for HCV. Four (0.062%) of the study’s participants were co-infected: 3 (75%) with HBV-HCV and 1 (25%) with HIV-HBV-HCV. Being a farmer, unemployed or employed donor was significantly associated with transfusion-transmissible viral infections compared to being a student donor.ConclusionThe prevalence of transfusion-transmissible viral infections is substantial and has increased overtime. Hence, it demands more vigilance in routine screening of donated blood prior to transfusion. Further community-based studies to identify societal risk factors are necessary.

Prevalence and Trends of Transfusion-Transmissible Viral Infections among Blood Donors in South of Iran: An Eleven-Year Retrospective Study.

BackgroundBlood transfusion is considered a potential risk factor for transmission of life-threatening viral infections, including HIV, HCV and HBV infections. This study was performed to find out the prevalence and trends of these infections among blood donors in Southern Iran.MethodsThe blood donor data recorded in twelve regional blood transfusion centers from 2004 to 2014 were analyzed in an anonymous way with respect to the results of serological screening for HBV, HCV, and HIV infections. Overall, 293454 donors were screened for viral infections.ResultsMost of the donors were male, married, aged between 20–40 years, educated, and regular donors. The overall seroprevalence rates of HBV, HCV and HIV were 0.15%, 0.1% and 0.004%, respectively. The highest seroprevalence was found for HBV, followed by HCV and HIV. These infections were more prevalent in male, low educated and first time donors. The highest HCV seroprevalence was observed among donors aged 20 to 40 years, while HBV seroprevalence increased with age. The seroprevalence rates of HBV and HCV from 2004 to 2014 showed significant decreasing trends from 0.460% to 0.060% (P < 0.001) and 0.329% to 0.045% (P < 0.001), respectively. Whereas HIV infection had a slight but not significant decline from 0.0173% in 2004 to 0.0028% in 2014 (P = 0.087).ConclusionsThe decreasing trends of transfusion-transmissible viral infections in blood donations indicate that the attempts of IBTO were successful in improving the safety of the blood supply, since the prevalence rates of viral infections have been reduced to very low levels in blood donations over the years. However, still more effective techniques such as polymerase chain reaction (PCR) are needed to guarantee blood safety.

Burden of transfusion transmissible viral infections among blood donors at a tertiary care referral teaching hospital in South India

Background: Blood serves as a vehicle for transmission of blood-borne pathogens including human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV). The present study was conducted to estimate the prevalence of these transfusion transmitted infections (TTIs) in blood donors. Methods: All blood donors presenting to the blood bank at our tertiary care teaching hospital were screened for HIV, HBV and HCV by using enzyme-linked immunosorbent assay (ELISA) method. Results: During the period January to December 2014, 9958 blood donors were screened for viral markers. The prevalence of HIV, HBsAg and HCV was 0.36%, 1.67%, and 0.56% respectively. Conclusions: Although multiple critical steps are taken to minimize the risk of infection from transfusion of blood or blood products, this risk can never be entirely eliminated. Stringent donor selection, proper counseling and deferral/ self exclusion may reduce the seroreactivity in donated blood and wastage of resources.

Seroepidemiology of Some Transfusion Transmissible Viral Infections in Jos, North-Central Nigeria

Background: Despite current efforts and availability of advanced technology such as nucleic acid amplification testing and Immunoassays, the risk of Transfusion Transmissible viral Infections (TTVIs) continues to exist. In low resource economies, where periodic large scale serosurveillance is impracticable; the use of donor seroprevalence to monitor the trends of epidemiologically significant TTVIs in adult population becomes imperative. This study therefore aimed to determine blood donor profile and seroepidemiology of HIV, HBV and HCV infection status in Jos North-Central Nigeria. Methods: A cross sectional study in which 510 prospective blood donors were recruited as they presented for donation at the National Blood Transfusion Service centre and Plateau Specialist Hospital Jos. Their blood samples were tested for HbsAg, anti-HCV, and HIV, using a third generation ELISA. Data analyzed with SPSS version 20, associations between categorical variables tested using Chi-square (χ2) test and P<0.05 was considered significant. There were 510 respondents, aged 18 to 65 years. Mean age ± SD was 30.20 ± 9.10. The overall prevalence of TTVIs was 15.5%. The prevalence of HBV, HIV and HCV were 7.5%. 3.1% and 2.7% respectively, while that of co infection HIV/HBV, HIV/HCV and HBV/HCV were 1.6%; 0.2%; and 0.4% respectively. Conclusion: There is a decline in the prevalence of TTVIs in Jos, North-central Nigeria, and there is a significant association between educational level and blood donation (P<0.05). We recommend a need to sustain the present policies, and efforts, donor education, implementation of stringent donor eligibility criteria and use of more sensitive viral genome detection methods to further minimize the risk

Seroprevalence of transfusion transmissible viral markers in sickle cell disease patients and healthy controls in Ile-Ife, South-Western Nigeria: A case–control study

Background: The risk of acquiring transfusion transmissible viral infections is said to be higher in patients requiring regular blood transfusions such as those with sickle cell disease (SCD). Aim: We determined the seroprevalence of blood transfusion viral markers among our patients with SCD. Subjects and Methods: This a case–control analytical study consisting of 82 confirmed SCD patients on routine follow-up at our facility in steady state and 90 age-matched controls. Demographic and transfusion history were recorded while 5 ml of blood was drawn for hematocrit levels, and serum tested for transfusion transmissible viral markers for hepatitis B, (hepatitis B surface antigen [HBsAg], hepatitis B surface antibody [HBsAb], hepatitis B e antigen [HBeAg], hepatitis B e antibody [HBeAb], hepatitis B core antibody [HBcAb]), hepatitis C virus (HCV) and human immunodeficiency viruses (HIVs) using the rapid test kits. Ethical approval for the study was obtained from the Institutional Review Board and each participant gave informed consent. Data were analyzed using descriptive and inferential statistics. Results: The seroprevalence of HBsAg, HBsAb, and HBeAg in cases was 2 (2.4%), 7 (8.5%), and 0 (0.0%), respectively, whereas it was 7 (8.5%), 11 (13.4%), 6 (7.3%), and 2 (2.4%) for HBeAb, HBcAb, HCV, and HIV antibodies. Compared to the controls, cases had higher prevalence rate of HBeAb (P = 0.005). No significant difference was observed in those with or without low hematocrit (≤18%) or those that received blood transfusion and those that did not (P > 0.05). Conclusion: We conclude that blood transfusion did not significantly increase the seroprevalence of markers of transfusion transmissible viral infection in SCD patients.

Human – T Lymphotropic Virus 1 (HTLV-1) Among Blood Donors in Ogbomoso, Oyo State, Nigeria

This study was designed to determine the seroprevalence of Human T- Lymphotropic Virus 1(HTLV-1) among blood donors in Ogbomoso, Oyo State, Nigeria Three hundred (300) consenting potential blood donors were recruited into the study over a period of three months (May to July, 2013). Each subject was screened for HIV, HBsAg and HCV and a structured questionnaire was administered. A total of 93 (male = 63; female = 30) subjects with mean age of 45±2.3 years previously tested negative for HIV, HBsAg and HCV were screened for HTLV-1 antibodies using Enzyme Linked Immunosorbent Assay (ELISA). Out of 93 subjects tested, 24 (25.8%) were positive for both anti-HTLV-1 IgM and anti- HTLV-1 IgG. Anti- HTLV-1 IgM was highest among the subjects in the age group 18-24, 13(39.4%), male 13(20.6%), single 14 (31.4%) and student 14 (37.8%) while Anti- HTLV-1 IgG was highest among the subjects in the age group 18-24, 15 (45.5%), female 12(19.1%), single 14 (27.5%) and student 14 (37.8%). These results provide more and further evidence that Human T-Lymphotropic Virus 1 is present among blood donors in Ogbomoso and is also one of the transfusion transmissible viral infections

Screening and confirmatory testing strategies for the major transfusion‐transmissible viral infections

BackgroundTesting donated blood for human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and human T‐cell lymphotropic virus (HTLV) is important as all are transfusion‐transmissible viral infections (TTVIs). A particular challenge in donor screening for TTVIs is that donor selection seeks to minimize the prevalence of TTVIs which in the context of testing substantially increases the likelihood that reactive test results represent ‘false’ rather than ‘true’ reactivity. To address this donor testing algorithms seek to combine strategies to optimize both sensitivity (optimal detection of the ‘target’ pathogen) and specificity (minimising ‘false’ reactivity)AimsFirst, review the fundamental principles underpinning TTVI screening and confirmatory algorithms and discuss key challenges. Second, using working examples illustrate how sound design can lead to optimal, cost‐effective solutions.Materials and MethodsScreening algorithms vary dependent on a number of factors including the epidemiology of the TTVI in the donor population and the available resources (e.g. funding, automation level, technical skill). TTVI screening tests include rapid tests (RT), immunoassays (IA) and nucleic acid tests (NAT). RTs and IAs target ‘serological’ markers of infection (anti‐HIV, HIV p24 antigen, anti‐HCV, HBsAg, anti‐HBc or anti‐HTLV) whereas NAT targets viral RNA (HCV and HIV) or DNA (HBV). NAT has the advantage of earlier detection because viral RNA/DNA appears in the bloodstream before serological markers. However NAT is comparatively expensive requiring higher levels of automation and more skilled staff. Confirmatory testing seeks to ‘confirm’ the presence of the pathogen of interest optimizing donor counselling and referral. The appropriate confirmatory strategy will be dependent primarily on the screening strategy and available resourcing.ResultsWhile optimal screening strategies for HIV, HCV and HBV generally include NAT for its superior ability to identify donors with early infection, there are alternative strategies which can provide almost equivalent safety. For example, the use of HIV and HCV ‘combo’ IAs which combine antibody with antigen (HIV p24Ag or HCV Ag) detection significantly improve sensitivity for early infection. In resource poor settings RT for HIV, HCV and to a lesser extent HBV can still provide a high level of safety particularly where carefully selected. Repeating samples reactive on a primary screening test on a second screening test (termed a ‘sequential immunoassay’ or SI algorithm) and assigning a final status based on concordant reactivity has been shown to improve effectiveness although is dependent on judicious test selection. For HIV, HCV and HTLV antibody based screening strategies immunoblots are often used to confirm the presence of antibody. However, immunoblots are relatively costly and can have poor specificity making it important to optimise the specificity of the screening algorithm. Immunoblotting subsequent to a sequential immunoassay approach has been shown to improve the efficiency and effectiveness of the strategy. Since NAT for HIV, HCV and HBV have demonstrated very high specificity, they now form an independent method of confirming infection for serology reactive samples. In some countries, samples concordantly reactive on serology and NAT screening tests are considered ‘confirmed’ without the need for immunoblotting.ConclusionsEven in resource constrained settings optimally designed screening and confirmatory strategies can significantly reduce the risk of transfusion‐transmissible viral infection.

Estimating window period blood donations for human immunodeficiency virus Type 1, hepatitis C virus, and hepatitis B virus by nucleic acid amplification testing in Southern Pakistan

Recently, strategic planning was initiated by the National Blood Transfusion Services Pakistan to improve its blood bank facilities. Emphasis has been placed on appropriate screening of blood products. Located in the southern region, Aga Khan University Hospital is a 700-bed tertiary care academic institute with comprehensive blood banking. Screening of blood donors has been based on verbal screening and serologic testing to date. Additionally, the need of implementing nucleic acid testing (NAT) was considered in 2011 because of an upsurge in hepatitis epidemiology. The aim of this study was to analyze the efficacy of this additional donor screening program and to evaluate the impact of NAT on the yield and residual risk of transfusion-transmissible viral infections. A total of 42,830 blood donations collected between 2011 and 2012 were screened for routine serologic assays. Only serologically negative donors (n=41,304) were tested for NAT. The frequency of viral infections was evaluated through serologic techniques and NAT yield for viral agents was estimated for computing window period donors. Residual risk per million donors was computed for viral infections in seronegative blood donors. Serologic work-up showed 1571 abnormal screening results in 1526 blood donors with the following results: hepatitis C virus antibodies (anti-HCV; n=708), hepatitis B surface antigen (n=555), human immunodeficiency virus antibodies (anti-HIV; n=29), malaria (n=30), VDRL (n=249), and coinfection (n=45). Thirty-five NAT-reactive samples were identified: HIV-1, one; HCV, 27; and hepatitis B virus (HBV), seven. Incident rates per 10(5) donors were highest for HCV (453.3) followed by HBV (171.5) and HIV (72.2). Calculated residual risk per million donors was highest at 1 in 10,900 for HBV, intermediate at 1 in 13,900 for HCV, and least at 1 in 62,600 for HIV. Incidence rates and estimated residual risk indicate that the current risk of transfusion-transmitted viral infections attributable to blood donation is relatively high in this country. The study recommends the parallel use of both serology and NAT screening of donated blood in countries that have high seroprevalence of these viral infections.

Transfusion transmissible viral infections among potential blood donors in Ibadan, Nigeria

It is evident that proper screening procedures prior blood transfusion is a cost-effective approach for prevention and control of transfusion-transmissible infections (TTIs). Also, it has been documented that sub-standard test kits are mostly used in resource limited settings for transfusion related diagnosis. However, the role of such practice in epidemiology of transfusion transmissible viral infections in a tertiary health care facility would give an insight to the rates of blood transfusion associated viral transmission in the community at large. Therefore, the study was designed to determine the prevalence of Human Immunodeficiency Virus (HIV), Hepatitis B and Hepatitis C viruses among blood donors in a tertiary hospital where quality diagnostic procedures are considered prior recruitment of donors. Post ethical approval, counselled and consenting 507(M= 426; F=81) aged 19 to 68 years (Median age:39) potential blood donors were recruited and tested for HIV, HBsAg and anti-HCV using commercial ELISA testkit in strict compliance with the manufacturer’sprocedures. Overall results show rates of 2.0%, 5.9% and 1.4% for HIV, HBsAg and HCV respectively. Also, highest prevalence rates were recorded among age group 26 to 35 years as 2.6%, 7.2% and 2.1% for HIV, HBV and HCV respectively. Furthermore, higher prevalences rates were noted among unmarried individuals as 2.6%, 6.8% and 2.1% for HIV, HBV and HCV respectively. Key words: Transfusion Transmissible Infections, HIV, Hepatitis B, Hepatitis C, Blood Donors, University College Hospital (UCH), ELISA.

Trends in prevalence, incidence, and residual risk of major transfusion‐transmissible viral infections in United Arab Emirates blood donors: impact of individual‐donation nucleic acid testing, 2004 through 2009

United Arab Emirates (UAE) has a heterogeneous population consisting of more than 160 nationalities and 85% of the population being non-UAE. In 2007, Dubai Blood Donation Centre (DBDC), the major local supplier of blood in the UAE, introduced six-minipool nucleic acid test (NAT) for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV), which in 2008 upgraded to individual-donation (ID)-NAT. The aim of this study was to analyze the efficacy of the donor screening program in the UAE and evaluate the impact of NAT on the yield and residual risk of transfusion-transmissible viral infections (TTVIs). A total of 169,781 blood donations collected at DBDC between 2004 and 2009 were screened for TTVIs. During the period 2008 through 2009, a total of 59,283 donations were tested with both ID-NAT and serologic assays. The incidence, prevalence, and residual risk for each viral agent were estimated and analyzed. The individual prevalences of HBV, HCV, and HIV per 100,000 donation were 234.4, 110, and 4, respectively. Calculated residual risk per million donations for HBV was decreased from 1.41 in pre-NAT period to 0.92 in post-NAT period. These figures were decreased for HCV and HIV from 1.73 and 0.39 to 0 and 0.32, respectively. Incidence rates and estimated residual risk indicate that the current risk of TTVIs attributable to blood donation is relatively low in the UAE. The study recommends the parallel use of both serology and ID-NAT TTVIs screening in blood donations and suggests the exclusion of antibody to hepatitis B core antigen-positive donations as this can eliminate the potential infectivity of these units with marginal effects on the blood stock in UAE.