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1.
Background
Hepatitis E, generally known to be transmitted faeco-orally, has been shown to have significant transmission by blood borne route. Paucity of data on asymptomatic viremia in blood donors and higher incidence of Hepatitis E in haemodialysis patients and thalassemics mandate a prospective study of blood recipients to elucidate the exact incidence and natural history of post transfusion Hepatitis E.Methods
A total of 2000 recipients of blood or blood products transfusion were followed up for two months to detect development of post transfusion Hepatitis E, by clinical examination, transaminases and immunoglobulin M anti hepatitis E virus (IgM anti HEV). Estimation of hepatitis E virus ribonucleic acid (HEV RNA) was done in patients with elevated levels of transaminases.Result
Out of 2000 patients, 5(0.25%) were positive for IgM anti HEV at the time of transfusion and were excluded from the study. Rest of 1995 patients were followed up for two months post transfusion. A total of 1303 (65.3%) patients were followed up for two months and 1636 (82.0%) patients at least once in two visits. None of the followed up patients reported development of jaundice or had clinically evident hepatitis, although 62 patients had raised transaminases detected at either one or both the visits.Conclusion
All followed up patients were tested for IgM anti HEV at both the visits and none were found to be positive. Patients with raised transaminases were subjected to HEV RNA and all were found to be negative.Key Words: Hepatitis E, Post transfusion, Parenteral transmission 相似文献2.
Background
This study presents data on the prevalence rate of infectious markers among voluntary and replacement donors in the blood transfusion service in Armed Forces from 2000 to 2004.Methods
39,646 units of blood were collected from donors during the period from 2000 to 2004. All the samples were screened for hepatitis B surface antigen (HBsAg), human immunodeficiency virus (HIV) 1&2, hepatitis C virus (HCV), and by venereal disease research laboratory test (VDRL).Results
24,527 (61.9%) were voluntary donations and 15,119 (38.1%) replacement donations. Prevalence of HBsAg had decreased, amongst voluntary donors from 1.67% to 0.77% but the positivity rate has not showed significant change. Seropositivity of HIV had decreased both in voluntary and replacement donors to 0.22% and 0.86% respectively. The seropositivity for anti-HCV showed steady decrease amongst voluntary donors from 0.46% to 0.20% in 2004, but in replacement donors, there was an increase in reactivity rate from 0.43% to 0.65%.Conclusion
The increased seropositivity for HCV, HIV and HBsAg could be decreased by introduction of nucleic acid amplification testing (NAT) in minipools for HCV and HIV and introduction of anti-HBcAg (IgM) for hepatitis B virus (HBV) infection. But this may not be possible in near future in developing countries due to financial constraints. At present implementation of strict donor criteria and with use of sensitive laboratory screening tests it is possible to reduce the incidence of transfusion transmitted infections (TTI) in Indian scenario.Key Words: Transfusion transmitted infections, Human immunodeficiency virus, Hepatitis C virus, Hepatitis B virus 相似文献3.
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.Key Words: Infectious disease, Blood donors 相似文献4.
Sourav Sen Shakti Prasad Panda K Shanmuganandan RM Gupta AK Praharaj 《Medical Journal Armed Forces India》2012,68(1):16-19
Background
The diagnosis of hepatitis B is routinely based on the detection of hepatitis B surface antigen (HBsAg) only. However, occult hepatitis B virus (HBV) infection (OBI), which is defined as infection with positive hepatitis B core antibody (anti-HBc) antibodies, positive DNA (deoxyribonucleic acid) PCR (polymerase chain reaction), and undetectable HBsAg, as well as anti-HBs antibodies in serum or plasma of HBV infected individuals, will remain undetected using this screening diagnostic approach of detecting HBsAg. The current study aims in studying the prevalence of the OBI amongst human immunodeficiency virus type 1 (HIV-1) infected individuals who have not been exposed to anti-retroviral therapy.Method
Estimation of HBsAg, anti-HBs, and anti-HBc total antibody status amongst 100 HIV-1 infected study participants was carried out using enzyme-linked immunosorbent assay (ELISA) kits. Detection of HBV-DNA was carried out by in-house qualitative PCR. CD4 + T lymphocyte counts were analysed using Becton Dickinson''s (BD) FACSCount™ system.Results
The median age of the HIV-1 infected study population was 35 years (range: 22–67), with the gender distribution being 53 males and 47 females. The mean CD4 T lymphocyte count of the study participants was 210/mm3. Overall, serological evidence of HBV infection was observed in 28% of the HIV-1 infected study participants. There was 5% seropositivity for HBsAg, of which 2% were additionally positive for HBV-DNA-PCR. “Anti-HBc alone” status was seen in 18% of study participants, this being statistically higher in those with CD4 T lymphocyte counts < 200/mm3. While there was a single specimen with co-positivity for anti-HBc total antibodies and HBV-DNA, 5% of the in the study population exhibited anti-HBs antibodies positivity, with one sample exhibiting dual positivity for HBsAg and anti-HBs antibodies.Conclusion
Occult HBV infections may contribute to chronic liver damage, and associ-ated reactivation amongst immunocompromised individuals, HIV-1 in-fected being a subset of them. “Anti-HBc” testing followed by HBV-DNA detection by PCR can be utilised for such populations to detect OBIs. Early detection of hepatitis B viraemia will be important for deciding the antiviral therapeutic protocol so as to avoid evolution of antiviral resistance in the circulating HBV strains in HIV-1 infected individuals harbouring OBIs.Key Words: human immunodeficiency virus, occult hepatitis B 相似文献5.
Satish Kumar R.M. Gupta Sourav Sen R.S. Sarkar J. Philip Atul Kotwal S.H. Sumathi 《Medical Journal Armed Forces India》2013,69(3):268-272
Background
Human parvovirus B19 is an emerging transfusion transmitted infection. Although parvovirus B19 infection is connected with severe complications in some recipients, donor screening is not yet mandatory. To reduce the risk of contamination, plasma-pool screening and exclusion of highly viraemic donations are recommended. In this study the prevalence of parvovirus B19 in healthy blood donors was detected by ELISA.Methods
A total of 1633 samples were screened for IgM and IgG antibodies against parvovirus B19 by ELISA. The initial 540 samples were screened for both IgM and IgG class antibodies and remaining 1093 samples were screened for only IgM class antibodies by ELISA.Results
Net prevalence of IgM antibodies to human parvovirus B19 in our study was 7.53% and prevalence of IgG antibodies was 27.96%. Dual positivity (IgG and IgM) was 2.40%.Conclusion
The seroprevalence of human parvovirus B19 among blood donor population in our study is high, and poses an adverse transfusion risk especially in high-risk group of patients who have no detectable antibodies to B19. Studies with large sample size are needed to validate these results. 相似文献6.
A.K. Agarwal Sourav Sen Debabrata Banerjee Rakesh Srivastava A.K. Praharaj 《Medical Journal Armed Forces India》2015,71(3):225-232
Background
Chronic hepatitis B (CHB) infection which is associated with an increased risk of developing liver disease including cirrhosis and hepatocellular carcinoma. Viral factors that may increase the risk for HCC development include HBV DNA level, genotypes, and naturally occurring mutations such as hepatitis B virus precore (PC) (G1896A) and basal core promoter (BCP) A1762T/G1764A double mutations. HBV genotypes and subgenotypes can significantly influence HBeAg seroconversion rates, viremia levels, mutational patterns that could significantly influence the heterogeneity in clinical manifestations and even response to antiviral therapy.Method
94 CHB infected individuals with detectable serum HBV DNA levels were studied. HBsAg, HBeAg, anti-HBc IgM antibody estimations were done by ELISA. HBV DNA estimation was done. The HBV genotypes were determined by TSP-PCR and 10 samples randomly selected for DNA sequencing. PC and BCP mutations were determined by DNA sequence analysis of core region.Result
Of 94 study participant samples with detectable serum HBV DNA levels, 75 were successfully genotyped and sequenced for BCP/PC region. 30/75 (40%) harbored PC and BCP mutations. The total Double mutations of BCP at A1762T/G1764A nucleotide positions, and PC mutation at G1896A nucleotide position were seen in 29.3% and 21.3%, respectively. All 75 isolates were subtype D using TSP-PCR. However, by sequencing 2/10 were subtype A, while 8 were subtype D.Conclusion
Our study reinforces that D is the predominant genotype in Indian population. It reveals that Indian CHB subjects have increased prevalence of BCP & PC mutations, which possibly may lead to development of HCC. 相似文献7.
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Background
Primary cytomegalovirus (CMV) infection in immunocompetent host is self limiting infection, leading to latency of virus. However congenital CMV and CMV infections in immunocompromised patients are associated with high morbidity and mortality. Transfusion transmitted-cytomegalovirus (TT-CMV) infection in low birth weight neonate and immunocompromised transfusion recipients is being increasingly reported. Studies recommended transfusion of CMV free or CMV safe blood in prevention of TT-CMV. In this background, the study was undertaken to assess the CMV seroprevalence in blood donor.Methods
A prospective study was conducted in which 431 voluntary blood donors were screened for CMV IgG and IgM by EIA (Enzyme Immuno Assay).Result
A total of 379 (87.9 %) voluntary blood donors were seropositive for CMV IgG. There was no statistical difference of CMV seropositivity and age. Further, seven (1.6%) subjects were both CMV IgM and IgG seropositive.Conclusion
High seroprevalence of CMV in our donor population is a threat to the blood safety. Strategies in reducing the risk of TT- CMV are discussed. Use of prestorage leucodepleted ‘CMV safe’ blood components along with judicious use of blood is recommended in prevention of TT-CMV in high risk recipients.Key Words: Cytomegalovirus, Transfusion transmitted infections, Blood donors, Leucodepletion 相似文献10.
Background
Since the adoption of a universal hepatitis B immunisation strategy, the reported incidence of acute hepatitis B has declined dramatically worldwide including in Israel. However, new cases of acute hepatitis B still occur. The aim of this study was to describe the incidence of acute hepatitis B in a referral area, routes of transmission, and outcome.Methods
The charts of all new hepatitis B patients, who visited the clinic in the years 2002 and 2003 (January 2002 to December 2003), were reviewed. The main criteria for a diagnosis of acute hepatitis B were transient increase of alanine transaminase activity, and hepatitis B surface antigen seroconversion.Results
Twenty nine men and seven women were diagnosed with acute hepatitis B infection during the study period. Two patients were previously vaccinated with hepatitis B vaccine. One case of hepatitis D coinfection was reported. The incidence of acute hepatitis B in the referral area was estimated as 2.25 per 100 000 adult population. Mean age was 36 years (17–75). Twenty one patients (18 men and 3 women) acquired the virus through unprotected sexual contact, and seven patients through iatrogenic exposure. Thirty three patients underwent spontaneous seroconversion while three patients became chronic carriers.Conclusions
Despite a universal immunisation policy, frequent cases of acute hepatitis B in Israel are still seen. High risk heterosexual activity and iatrogenic exposure seem to be the commonest routes of transmission. Further recommendations regarding vaccination policy are discussed. 相似文献11.
Sourav Sen Shakti Prasad Panda K Shanmuganandan RM Gupta AK Praharaj 《Medical Journal Armed Forces India》2012
Background
The diagnosis of hepatitis B is routinely based on the detection of hepatitis B surface antigen (HBsAg) only. However, occult hepatitis B virus (HBV) infection (OBI), which is defined as infection with positive hepatitis B core antibody (anti-HBc) antibodies, positive DNA (deoxyribonucleic acid) PCR (polymerase chain reaction), and undetectable HBsAg, as well as anti-HBs antibodies in serum or plasma of HBV infected individuals, will remain undetected using this screening diagnostic approach of detecting HBsAg. The current study aims in studying the prevalence of the OBI amongst human immunodeficiency virus type 1 (HIV-1) infected individuals who have not been exposed to anti-retroviral therapy.Method
Estimation of HBsAg, anti-HBs, and anti-HBc total antibody status amongst 100 HIV-1 infected study participants was carried out using enzyme-linked immunosorbent assay (ELISA) kits. Detection of HBV-DNA was carried out by in-house qualitative PCR. CD4 + T lymphocyte counts were analysed using Becton Dickinson's (BD) FACSCount™ system.Results
The median age of the HIV-1 infected study population was 35 years (range: 22–67), with the gender distribution being 53 males and 47 females. The mean CD4 T lymphocyte count of the study participants was 210/mm3. Overall, serological evidence of HBV infection was observed in 28% of the HIV-1 infected study participants. There was 5% seropositivity for HBsAg, of which 2% were additionally positive for HBV-DNA-PCR. “Anti-HBc alone” status was seen in 18% of study participants, this being statistically higher in those with CD4 T lymphocyte counts < 200/mm3. While there was a single specimen with co-positivity for anti-HBc total antibodies and HBV-DNA, 5% of the in the study population exhibited anti-HBs antibodies positivity, with one sample exhibiting dual positivity for HBsAg and anti-HBs antibodies.Conclusion
Occult HBV infections may contribute to chronic liver damage, and associ-ated reactivation amongst immunocompromised individuals, HIV-1 in-fected being a subset of them. “Anti-HBc” testing followed by HBV-DNA detection by PCR can be utilised for such populations to detect OBIs. Early detection of hepatitis B viraemia will be important for deciding the antiviral therapeutic protocol so as to avoid evolution of antiviral resistance in the circulating HBV strains in HIV-1 infected individuals harbouring OBIs. 相似文献12.
A Banerjee AK Sahni Rajiva A Nagendra GS Saiprasad 《Medical Journal Armed Forces India》2005,61(4):326-329
Background
An outbreak of viral hepatitis occurred in a regimental centre with 265 cases occurring during a 3 months period.Methods
190 serum samples were tested for IgM antibodies against viral hepatitis E by Enzyme Immuno Assay (EIA) and for antibodies against Hepatitis A and Hepatitis B viruses. Epidemiological investigation comprised review of surveillance data, filling up epidemiological case sheet, sanitary survey, inspection of water supplies and bacteriological examination of water for coliforms.Result
97.4% of the serum samples were positive for IgM antibodies against Hepatitis E virus. Two leaks were detected in water pipelines, which were passing through contaminated areas around improperly functioning septic tanks and soak pits. The attack rate among recruits being supplied water through leaking pipelines was 11.1% whereas it was 2.89% in those not directly exposed. This difference was statistically significant (p<0.001). Bacteriological examination of water showed a high coliform count.Conclusion
The outbreak of viral hepatitis E occurred due to sewage contamination of water pipelines.Key Words: Hepatitis E, Outbreak 相似文献13.
目的：了解我区献血员的管理及筛查情况。方法：随机采集了我区4个盟市血站503份合格献血员血样,并进行了相关调查,采用ELISA法复检。结果：HBsAg阳性率为1.99%（10/503）;抗-HBc阳性率15.90%(80/503);抗-HBs阳性率21.87%(110/503);抗-HCV阳性率2.19%(11/503),其中HBV、HCV双重感染的8例,HBsAg、抗-HBc双阳性3例。对抗-HBc、抗-HBs双阳性以及单纯阳性者经PCR法检测HBVDNA均为阴性。结论：说明我区血站管理及对献血员筛查工作还存在着一定的漏洞,献血员筛查抗-HBc对预防输血后乙肝无多大价值,应把重点放在选用灵敏度高的试剂进行筛查。 相似文献
14.
J Philip RS Sarkar Satish Kumar Amardeep Pathak 《Medical Journal Armed Forces India》2012,68(1):28-32
Background
The main blood borne viruses'' viz. hepatitis B virus (HBV), human immunodeficiency virus (HIV), and hepatitis C virus (HCV), are a major public health issue, and represent significant causes of morbidity and mortality associated with transfusion. This study analysed the trends of blood borne infections among blood donors in a large blood bank in the last 10 years.Method
Viral screening results of 80,500 voluntary and replacement donations from 2000 to 2009 were analysed. All donations were screened for HBV, HCV, and HIV. The seroprevalence rate of HBV, HCV, and HIV infections and 95% confidence interval were calculated.Results
The seroprevalence rate of HBV, HIV, and HCV, decreased during the last 10-years study from 2000 to 2009. There is significant and impressive decrease in HBV seroprevalence rate from 2.39% in 2000 to 1.28% in 2009. The seroprevalence rate of HIV appeared to have decreased with a very significant value from 1.32% to 0.30% in 2009. Hepatitis C virus seroprevalence rate showed a slight decline in blood donations from 0.48% in 2001 to 0.22% in 2009.Conclusion
There is a general reduction in the seroprevalence rate of viral infections. This is probably because of discouragement of professional or paid donations; better awareness, better prophylactic measures, and availability of vaccines have played a major role.Key Words: transfusion transmitted infections 相似文献15.
Background
This study was undertaken to study the motivational factors leading to voluntary blood donation and understanding the psychosocial variables of blood donors.Methods
300 blood donors were selected by systematic random sampling method.Result
It was observed that most of the voluntary donors were males (89.3%) and belonged to age group 16-25 years (48%). Most of the donors (93.46%) had studied upto high school and above and 84.33% of the donors belonged to the middle class. 27% of the donors had donated blood previously. The common motivational factors to donate blood were for ‘a good cause'', ‘for the society’ and ‘to save a life''. 4.67% of them donated blood for self satisfaction.Conclusion
Motivation, recruitment and retention of voluntary blood donors are important criteria to achieve safe blood donation.Key Words: Motivation, Psychosocial, Voluntary, Blood Donors 相似文献16.
KK Lahiri AK Sahni RM Gupta SD Duhan K Kapila J Jena 《Medical Journal Armed Forces India》2007,63(4):318-321
Background
Hepatitis B e antigen negative chronic hepatitis (e− CHB) with detectable levels of hepatitis B virus DNA (HBV DNA) in serum has been reported in cases from Asia. This study was undertaken to find out prevalence e−CHB and to correlate its presence with the clinical status and severity of the illness in cases of chronic liver disease in India.Methods
All patients of infective hepatitis, who were hepatitis B surface antigen (HBsAg) positive by enzyme-linked immunosorbent assay (ELISA), were evaluated with liver function tests and HBeAg and antiHBe antibody studies. Polymerase chain reaction (PCR) test was carried out to detect HBV DNA qualitatively.Result
Out of 2064 samples tested by ELISA, 429 (20.78 %) were HBsAg positive. HBV DNA (qualitative) was performed on all 429 patients and 74 (17.2%) were HBV DNA positive. Of these only 42 (56.75 %) tested positive for HBeAg. Overall, 8.3 % of HBeAg negative patients (32/384) were viraemic with evidence of chronic liver disease/clinical cirrhosis and alteration of transaminase levels, while three cases (0.84 %) HBeAg positive cases did not show presence of HBV DNA.Conclusion
This study shows e−CHB prevalence rate of 8.3% in patients with HBV infection in India. Since HBeAg negative patients had detectable levels of HBV DNA as seen in HBeAg positive patients, benefit of antiviral therapy should be given to them. Population studies on e− CHB cases are needed to determine its true prevalence, natural course and response to therapy.Key Words: Chronic hepatitis, Hepatitis B virus, Hepatitis B e antigen negative 相似文献17.
Background
Transfusion Transmitted Virus (TTV), also known as Torque Teno Virus is a new novel viral agent which appears to correlate with some acute and chronic hepatitis cases and may produce liver damage under specific circumstances. Aim of this study was to detect TT virus by real-time PCR, study its clinical implications and effects of its co-infection in HBV and HCV chronic liver diseases.Methods
The study population comprised 50 acute hepatitis, 50 chronic hepatitis patients and 100 voluntary blood donors. All samples were tested for serum bilirubin, AST, ALT and alkaline phosphatase levels and for all available viral markers for hepatitis. The detection of TT viral genome was carried out by real-time PCR using TTV sequences as reported by Takahashi et al with modifications on the basis of database of the DDBJ/EMBL/GenBank (GenBank accession no. AB008394).Result
Serum was positive for TTV in 72% of volunteer blood donors, 77.4% (24/31) of hepatitis A cases, 87.6% (36/41) of HBV-positive, 77% (10/13) of HCV-positive, and 92.8% (13/14) of non-B, non-C cases. Co-infection of TTV with other hepatitis viruses was detected in some patients.Conclusion
TTV is a frequent virus detected in patients with various types of viral hepatitis, in cases of hepatitis without obvious viral agent, and from the healthy population in India. Rate of TTV was found to be significantly higher (92.8%) for Non A–E hepatitis group. 相似文献18.
Doudou Yobi Renaud Piarroux Coralie L'Ollivier Jacqueline Franck Hypolite Situakibanza Hypolite Muhindo Patrick Mitashi Raquel Andreia Inocêncio da Luz Marc Van Sprundel Marleen Boelaert Jean-Pierre Van Geertruyden Pascal Lutumba 《Asian Pacific Journal of Tropical Biomedicine》2014,4(1):69-74
Objective
To determine the seroprevalence of toxoplasmosis in pregnant women, as well as the proportion of acutely infected and risk factors in the Democratic Republic of Congo.Methods
Thirty maternities in Kinshasa were randomly selected and women attending antenatal consultation were invited to participate. They were interviewed with a structured questionnaire about known risk factors (age, meat consumption, contact with soil, and presence of cat) and a venous blood sample was taken. Sera were analysed for total immunoglobulins (Ig) by VIDAS Toxo Competition using Enzyme Linked Fluorescent Assay. IgM was determined by VIDIA Toxo IgM and IgG avidity by VIDAS Toxo IgG avidity.Results
A total of 781 women were included. Median age was 28 years old (IQR: 8.5). And 627 women (80.3%; 95% CI: 77.5-83.1) were found to be positive to total Ig and 17 out of 387 (4.4%; 95% CI: 2.3-6.4) were positive to IgM. IgG avidity was low for 2 (11.8%) women, intermediate for 2 (11.8%) and high for 13 women (76.4%). There was no statistically significant association between Toxoplasma gondii infection and any risk factors assessed.Conclusion
In Kinshasa, toxoplasmosis endemicity is highly prevalent. One woman out of twenty five had a recent toxoplasmosis infection and 20% were not protected against primo-infection, indicating a need for measures to prevent and control toxoplasmosis during pregnancy. 相似文献19.
Background
The incidence of hepatitis-A among adults in India is on the decline as majority develops protective immunity to it by late adolescence. Most of these studies are from northern India. Clinical spectrum of sporadic acute viral hepatitis from southern India has not been well documented.Methods
A prospective hospital based study was conducted in a large military hospital in southern India. 224 consecutive patients with acute viral hepatitis were studied for their presentation, etiology and clinical features.Result
Hepatitis-E was detected in 102 (45.4%), hepatitis A in 74 (33%) and hepatitis B in 28 (12.5%) patients. Acute hepatitis C was detected in two patients. 15 patients had a mixed infection. Hepatitis A constituted 41.2% and 31.3% of all cases in the age groups 11-20 and 21-30 years respectively. Cholestasis was present in 68 (30.4%) patients with hepatitis E accounting for most (61.8%) cases. There were four (1.8%) cases of acute liver failure. Two cases were due to hepatitis E and one case each was due to hepatitis A and hepatitis B. A relapsing course was seen in four cases due to hepatitis-A.Conclusion
Hepatitis A remains a significant cause of sporadic acute viral hepatitis in young adults in southern India.Key Words: Viral hepatitis, Hepatitis A 相似文献20.
MP Cariappa J Jayaram Rajvir Bhalwar AK Praharaj VK Mehta LK Kapur 《Medical Journal Armed Forces India》2004,60(3):251-254