广州地区首次参加无偿献血人群HCV感染的流行病学调查

目的了解广州地区首次参加无偿献血人群HCV的感染状况。方法抗-HCV检测采用酶联免疫吸附实验(使用2种不同厂家的试剂盒),HCV RNA检测采用荧光定量PCR法,ALT检测采用速率法。结果2004—2007年在广州血液中心首次参加无偿献血的559890名献血者中,1617名经双试剂检测抗-HCV阳性,阳性率为0.289%。随机选取435名双试剂检测抗-HCV阳性血液标本进行RNA检测,266名阳性,占61.15%,男女(P<0.01)HCV RNA阳性率有统计学意义(P<0.01)。266名抗-HCV检测阳性献血者中,ALT升高(>40U)的为18名(其中男性17名),不合率为6.77%,男女ALT的不合格比有统计学意义(P<0.01)。结论随着无偿献血的开展,献血人群中HCV的阳性率不断下降;不同性别的个体清除HCV的能力不同,女性高于男性。     

西北部分地区无偿献血人群HCV感染的分子流行病学的研究

目的探讨西北部分地区无偿献血人群中丙型肝炎病毒(HCV)基因型(亚型)的分布。方法收集无偿献血人群中HCV RNA阳性标本,通过RT-PCR扩增NS5B基因,测定其核苷酸序列后,与Genebank中已知序列进行分子进化分析,确定HCV基因型(亚型)。结果对西北部分地区(新疆、陕西、青海)137例HCV RNA阳性血清进行NS5B基因扩增,扩增阳性128例,其中1b占43.00%(55/128),2a占35.16%(45/128),3a占9.38%(12/128),3b占10.16%(13/128),6a占2.34%(3/128)。1b亚型之间同源性最高为99%,最低为93%,2a亚型之间同源性最高为98%,最低为91%,3a亚型之间同源性最高为98%,最低为91%,3b亚型之间同源性最高为98%,最低为93%。结论西北部分地区无偿献血人群中HCV基因分型以1b和2a为主,3a,3b,6a亚型占的比例较低,和中国内陆地区的基因型分布相似。     

云南和山西无偿献血人群HCV部分基因的核苷酸序列测定及基因分型

目的了解云南和山西2地无偿献血人群丙型肝炎病毒(HCV)的基因型分布及其差异。方法采用荧光定量PCR(Q-PCR),对所收集的203份ELISA检测抗-HCV阳性的无偿献血者标本(云南102份,山西101份)做核酸检测,对核酸阳性的标本做E1基因扩增和测序;E1基因阴性者,进一步做NS5B基因扩增;采用DNASTAR、Bi-oedit和Mega4等软件对E1、NS5B基因进行分析及分子进化研究。结果203份ELISA检测抗-HCV阳性的无偿献血者标本中,云南102份标本经Q-PCR检测出核酸阳性55份,从中扩增出E1基因43份,补做NS5B基因扩增获得阳性结果8份;山西省101份标本经Q-PCR检测出阳性46份,从中扩增出E1基因33份,补做NS5B基因扩增获得阳性结果6份。云南省献血者HCV基因型(亚型)可分为7种:1b[7.84%(4/51)]、2a[13.73%(7/51)]、3a[17.65%(9/51)]、3b[41.18%(21/51)]、6a[7.84%(4/51)]、6n[9.80%(5/51)]和6v[1.96%(1/51)];山西省献血者HCV基因型(亚型)较简单,可分为3种:1b[89.74%(35/39)]、2a[7.69%(3/39)]和3b[2.56%(1/39)]。结论我国云南和山西2地无偿献血人群中的HCV基因型(亚型)的分布存在明显的差异。     

TRANSFUSION COMPLICATIONS: Declining hepatitis C virus (HCV) prevalence in pregnant women: impact of anti‐HCV screening of donated blood

BACKGROUND: Screening blood donors for hepatitis C virus (HCV) antibody has effectively mitigated transfusion transmission of HCV. We conducted a post hoc analysis to clarify the impact of donor screening on a general population of reproductive‐age females and their offspring. STUDY DESIGN AND METHODS: Anti‐HCV screening in Japan started in late‐1989. In a cohort studied between May 1990 and November 2004, a total of 22,664 consecutive serum samples from pregnant women were screened for anti‐HCV. Reactive samples were further tested for HCV RNA. Linear structural regression was applied to identify causal relationships. RESULTS: Anti‐HCV–reactive rates declined significantly by two measures. First, among women known to have been transfused, rates fell from 14.8% to 3.1% with the implementation of anti‐HCV screening (p < 0.01). Nevertheless, this is 10 times higher than the 0.3% reactive rate seen in a similar cohort of nontransfused women. Second, rates fell from 1.8% among women born in 1955 or before to 0.3% for women born in 1966 or later (p < 0.01). Among 103 anti‐HCV–reactive women, 31 (30%) had been transfused and another 17 (17%) had other identifiable risk factors. The remaining 55 (53%) had no clear risk factor. Blood transfusion accounted for 19% of anti‐HCV acquisition, by path analysis. Only one infant in this cohort was vertically infected with HCV. CONCLUSION: Anti‐HCV screening of donated blood and hygienic improvements have markedly decreased HCV infection of pregnant women with a transfusion history; however, 70% of anti‐HCV–reactive women were deemed to be infected via routes other than transfusion.     

Relative safety of first‐time volunteer and replacement donors in West Africa

BACKGROUND: A significantly higher level of safety between nonremunerated volunteer and replacement donor blood is assumed. This is supported by global data without stratifying between genuine replacement and paid donors, for first‐time or repeat volunteer, or according to age. STUDY DESIGN AND METHODS: In 2008, first‐time volunteer and replacement donors were identified, and confirmed human immunodeficiency virus antibody (anti‐HIV), hepatitis B surface antigen (HBsAg), and hepatitis C virus antibody (anti‐HCV)‐positive screening results were collated. Data were analyzed according to age and sex between the two types of donors. RESULTS: In 6640 first‐time volunteer and 4360 replacement donors, the prevalence of anti‐HIV and HBsAg (1.03 and 13.8% vs. 1.1 and 14.9%, respectively) was not significantly different. Anti‐HIV prevalence was higher in replacement donors less than age 20 than in first‐time volunteers; the difference was not significant. HBsAg and anti‐HIV confirmed‐positive prevalence was significantly higher in first‐time volunteer donors over age 20. CONCLUSION: In Kumasi, Ghana, viral safety of replacement and first‐time volunteer donors was similar, constituting a single population of donors. Safety increment is provided by repeat donation applicable to either group, through different approaches. A blood unit from replacement donor costs half or less than that from a volunteer donor; similar studies conducted elsewhere in sub‐Saharan Africa may lead to changes in current strategies.     

献血人群中SEN病毒感染的检测分析

目的：了解国内献血人群中一种新的比血传播病毒（SENV）感染的流行状况，方法：以SENV ORF1区核苷酸序列设计引物建立套式聚合酶链反应（nPCR）方法。采用多重PCR法对596份严自3个不同地区无偿和／或有偿献血标本进行SENV DNA（D和H亚型）检测，并对PCR阳性产物进行克隆后测序分析。结果：在体检合格的献血中，SENVDNA检出率为13．5％－21．0％在抗－HCV，HBsAg，抗－HIV，梅毒抗体阳性和ALT异常升高的献血中，SENV DNA检出率分别为35．0％、14．0％，60．0％、28．6％和31．3％，献血中SENV－D亚型等高于SENV－H亚型，不同地域献血SENV DNA检出率的差异无显性（P＞0．05），体检不合格献血（抗－HIV或抗－HCV阳性的SENV－D感染率显高于正常献血人群（P＜0．05）；6份严自不同个体和不同地域之间的SENV分离株部分基因组核苷酸的变异最高达11．9％，与标准标（AX025838）相比变异高达13．2％，结论：在国内献血人群中存在SENV感染。     

广州地区无偿献血人群HCVE1和NS5B基因的测序和分型

目的了解广州地区无偿献血人群丙型肝炎病毒部分基因的核苷酸序列和基因型分布。方法收集广州地区无偿献血人群中抗-HCV阳性标本201份,采用荧光定量PCR(Q-PCR)的方法对其进行核酸检测,阳性标本同时作HCVE1和NS5B基因扩增;核苷酸序列测定后运用DNASTAR,B ioEd it,M ega4.0等软件作序列分析和基因分型。结果 201份抗-HCV阳性标本的HCV RNA阳性率为54.23%(109/201),其中男性的HCV RNA阳性率为63.19%(91/144)、女性为31.58%(18/57)(P<0.05)。109份HCV RNA阳性的标本全部扩增出E1和NS5B基因,基因分型显示其HCV基因型比例依次为1b(46.79%)、6 a(33.03%)、3 a(10.09%)、2 a(5.50%)、3b(3.67%)、1 a(0.92%)。结论广州地区抗-HCV阳性的无偿献血人群HCV RNA阳性率男性高于女性,HCV毒株以1b和6 a亚型最多见。     

Prevalence of serologic markers for hepatitis B and C viruses in Brazilian blood donors and incidence and residual risk of transfusion transmission of hepatitis C virus

BACKGROUND: We evaluate the current prevalence of serologic markers for hepatitis B virus (HBV) and hepatitis C virus (HCV) in blood donors and estimated HCV incidence and residual transfusion‐transmitted risk at three large Brazilian blood centers. STUDY DESIGN AND METHODS: Data on whole blood and platelet donations were collected from January through December 2007, analyzed by center; donor type; age; sex; donation status; and serologic results for hepatitis B surface antigen (HBsAg), antibody to hepatitis B core antigen (anti‐HBc), and anti‐HCV. HBV and HCV prevalence rates were calculated for all first‐time donations. HCV incidence was derived including interdonation intervals that preceded first repeat donations given during the study, and HCV residual risk was estimated for transfusions derived from repeat donors. RESULTS: There were 307,354 donations in 2007. Overall prevalence of concordant HBsAg and anti‐HBc reactivity was 289 per 100,000 donations and of anti‐HCV confirmed reactivity 191 per 100,000 donations. There were significant associations between older age and hepatitis markers, especially for HCV. HCV incidence was 3.11 (95% confidence interval, 0.77‐7.03) per 100,000 person‐years, and residual risk of HCV window‐phase infections was estimated at 5.0 per million units transfused. CONCLUSION: Improvement in donor selection, socioeconomic conditions, and preventive measures, implemented over time, may have helped to decrease prevalence of HBV and HCV, relative to previous reports. Incidence and residual risk of HCV are also diminishing. Ongoing monitoring of HBV and HCV markers among Brazilian blood donors should help guide improved recruitment procedures, donor selection, laboratory screening, and counseling strategies.     

重庆地区无偿献血者丙肝病毒感染及对献血者招募的影响

近年来，中国的献血者招募模式正在从有偿献血到单位组织献血，进而到完全无偿献血的模式转变。有关真正的无偿献血者中丙型肝炎感染的资料还较少报道。本研究对重庆地区2003年的首次献血者进行丙型肝炎感染及病毒分型的调查，共有13620份血清标本进行ELISA丙型肝炎抗体检测，其中抗体阳性标本再经RT—PCR扩增HCVRNA的核心区／＆区片段进行基因分型。结果发现，HCV抗体阳性率为0．49％（67／13620），其中在40—49岁年龄段的阳性率（0．86％）最高；高学历人群和大城市生活人群的阳性率相对为高。丙肝病毒的基因分型结果显示，在22份基因分型阳性标本中有基因型1b，2a，3a和3b等四种，分别占4（18％）、5（23％）、9（41）和4（18％），以基因型3（包括3a和3b）为流行。结论：重庆地区无偿献血人群中丙型肝炎抗体阳性率较低；由于本地及周边地区静注毒品人群中丙型肝炎感染以基因型3为主，提示可能在献血人群中有静注吸毒者的存在。因此，随着献血模式的转变，在献血者的招募中应注意排除吸毒者这一高危人群。     

广州地区抗-HCV阳性献血者核酸检测及随访

目的探讨广州地区无偿献血人群HCV感染者自然转归的相关因素。方法对ELSIA法检测为抗-HCV阳性的193名献血者采用荧光定量PCR法检测其HCV RNA,半年后随访并再次做抗-HCV和HCV RNA检测。结果 193名未经治疗的抗-HCV阳性献血者随访前后2次检测的HCV RNA及抗-HCV结果无变化;分别按性别、年龄比较其HCV RNA阳性比例:男性为60.5%(69/114)、女性为34.2%(27/79)(P0.01),35～55岁组为60.9%(42/69)、18～35岁组为43.5%(54/124)(P0.05)。结论女性HCV感染者的自然转归明显好于男性感染者,18～35岁HCV感染者的自然转归优于35～55岁感染者,提示性别及年龄均为HCV感染者自然转归的影响因素。     

丙型肝炎病毒不同区抗原酶免疫试剂研究

目的　探讨丙型肝炎病毒（ＨＣＶ） 不同区抗原的反应性,为建立抗ＨＣＶ 酶免疫测定（ＥＩＡ） 确认试剂提供依据。方法　利用基因工程技术,重组所表达的ＨＣＶ 不同区抗原片段（ ＨＣＶＣ、ＮＳ３ 、ＮＳ４ 、ＮＳ５） ,建立了ＨＣＶ 单片段抗原ＥＩＡ 检测方法,检测了７４７ 份四川地区献血员血清。对其中３７３ 份血清,用２ 个厂生产的经批检合格的抗ＨＣＶＥＩＡ 试剂进行检测比较,对个别结果不符的样品进一步进行逆转录聚合酶链反应（ＲＴ－ ＰＣＲ） 分析。结果　献血员中抗ＨＣＶＣ 等４ 种抗体阳性检出率分别为４ ．６８ ％ （３５／７４７） 、５ ．２ ％ （３９／７４７） 、１ ．１ ％ （８／７４７） 、１ ．２ ％ （９／７４７） ,２ 家试剂阳性检出率均为４ ％（１５／３７３） 。结论　ＨＣＶ 不同区抗原片段的抗体检出率差异较大,ＮＳ３ 检出率最高,其次为Ｃ 区、ＮＳ５ 、ＮＳ４ 。说明抗ＨＣＶＥＩＡ 检测试剂以ＨＣＶ ＮＳ３ 区和Ｃ 区为主要抗原片段。     

Hepatitis C virus (HCV)‐specific T‐cell responses among recombinant immunoblot assay‐3–indeterminate blood donors: a confirmatory evidence of HCV exposure

BACKGROUND: Blood donors are routinely screened for hepatitis C virus (HCV) infection. Some show weak anti‐HCV responses, often restricted to a single antigen on confirmatory immunoblot (recombinant immunoblot assay [RIBA]) testing. The aim of this study was to investigate the extent to which such RIBA‐indeterminate donors had previously been exposed to HCV. STUDY DESIGN AND METHODS: T‐cell responses to HCV recombinant proteins (core, NS3, and NS3 helicase) were analyzed using an interferon‐γ (IFN‐γ) enzyme‐linked immunospot (ELISpot) assay and quantification of cytokines in culture supernatants in 27 RIBA‐indeterminate donors, 60 RIBA‐confirmed donors (48 with and 12 without HCV RNA), and 30 RIBA‐negative donors. RESULTS: HCV‐specific T‐cell responses were identified in 13 (48%) RIBA‐indeterminate donors, 33 (55%) RIBA‐confirmed donors, and 4 (13%) RIBA‐negative controls (p = 0.008 and p < 0.001, respectively). The magnitude of the T‐cell response among indeterminate donors was similar to that of RIBA‐confirmed donors for all HCV antigens and the specificity of the ELISpot results was confirmed by antigen‐specific cytokine production (interleukin‐2 and IFN‐γ) in short‐term culture supernatants. CONCLUSIONS: These findings confirm that approximately half of RIBA‐indeterminate donors have resolved a previous HCV infection and suggest that ELISpot might be a useful tool to clarify the status of such donors and help in their counseling and management.     

某地区无偿献血者中性粒细胞特异性抗体筛查分析

目的探讨河南地区无偿献血者中性粒细胞特异性(HNA)抗体的分布和特异性,分析HNA抗体引起的免疫性输血不良反应。方法随机收集女性标本156例,男性标本80例,采用LABScreen Multi试剂盒对标本HNA抗体进行检测。结果 236例无偿献血者中,女性HNA抗体检出阳性率为5.77%(9/156),男性为5.00%(4/80)。其中HNA 1A者7例,HNA4A者4例,同时检出HNA 1A和HNA 4A、HNA 1A和HNA 1C各1例。结论 HNA抗体分布无性别差异,研究HNA抗体的分布和特异性,可为指导临床用血安全和相关政策的制定提供有力的理论基础。     

湖北地区抗-HCV阴性献血者丙型肝炎病毒核酸流行率研究(1 993年～2000年)

本文作者采用分子技术、首先用PCR-混合血清法对1993年～2000年间湖北地区库血中传播HCV的危险度进行了评估,提出各地采血应考虑当地献血人群HCV抗体流行率背景,对湖北地区抗-HCV阴性献血者进行HCV RNA监测结果表明无偿献血者中HCV RNA阳性率为0.19%(1/520),显著性地低于定期供全血者中2.15%(45/2096)和定期供血浆者的7.29%(29/398).湖北地区定期供血者HCV基因型主要为Ⅱ型.研究结果表明,HCV RNA检测用于献血者筛查对于最大限度控制输血传播HCV具有重要意义.     

深圳献血者中HCV感染自然清除与病毒血症特征分析

目的测定我国深圳地区献血者中的丙型肝炎病毒(hepatitis C virus,HCV)感染者自然清除和病毒血症,即自然康复与慢性感染者比率及其人群特征,为丙型肝炎防治研究提供数据。方法对深圳献血者中抗-HCV初筛阳性的血清标本采用2种EIA方法进行抗体再测定,以定量PCR方法测定病毒载量,并采用巢式PCR对核酸进行确认,进而将标本分为3种HCV感染状态,即病毒自然清除(RNA-/Ab+)、病毒血症(RNA+/Ab+)和假阳性(RNA-/Ab-),通过统计学方法分析3种感染状态献血者在临床信息(性别、年龄)、ALT、抗-HCV的差异。HCV RNA阳性标本通过分析5'-NCR序列进行基因分型。结果 152份初筛抗-HCV阳性的标本中,病毒自然清除标本45份、病毒血症51份、假阳性56份。50份HCV定量PCR阳性标本病毒载量范围从[(12.6～2.43)×106]IU/ml(中位值2.54×104IU/ml)。36份进行基因分型的标本包括47.2%基因1型、5.6%基因2型、19.4%基因3型和27.8%基因6型。慢性感染组标本的年龄及抗-HCV水平(S/CO值)显著高于病毒自然清除和假阳性组(χ2=7.812,P0.05;χ2=90.865,P0.01)。结论深圳地区献血者HCV感染病毒自然清除率约为46.9%。HCV基因型中1型为主要,6型也占有较高比例。年龄小、女性献血者更易于自然清除病毒。病毒血症即慢性感染者HCV抗体水平显著升高,其在HCV自然康复过程中的作用还有待进一步研究。     

中国部分民族献血者抗-HCV阳性率的调查

目的了解中国不同民族献血者抗-HCV阳性率差异和分布情况。方法选择国内8个省、市、自治区41个民族的30余万名献血者,用ELISA法测定抗-HCV。结果①首次献血者血清样本抗-HCV阳性率0.98%(676/68782),≥2次献血者血清样本抗-HCV阳性率0.71%(1750/245137),全部献血者血清样本抗-HCV阳性率0.77%(2426/313919);首次献血者抗-HCV阳性率明显高于多次献血者和全体献血者(P<0.01)。②汉族与少数民族献血者抗-HCV阳性率分别为0.75%(1834/245501)和0.87%(592/68418),两组抗-HCV阳性率有明显差异(P<0.05)。③汉族献血者与各个少数民族献血者抗-HCV阳性率分别比较:高于汉族的少数民族有:壮族(1.07%),朝鲜族(1.07%),维吾尔族(1.65%),仫佬族(2.26%);低于汉族的少数民族有:回族(0.51%),白族(0.10%);与汉族无明显差异的少数民族有:蒙古族(0.79%),苗族(0.73%),满族(0.89%),藏族(0.87%),瑶族(0.99%),哈萨克族(0.83%)。8省(自治区)之间献血者抗-HCV阳性率比较,有明显差异(0.10%~1.69%)。结论8省(自治区)和41个民族献血者抗-HCV阳性率差异明显;此资料可供各地采供血机构参考。     

Correlates of hepatitis C virus (HCV) RNA negativity among HCV-seropositive blood donors

BACKGROUND: Approximately 20 percent of persons infected with hepatitis C virus (HCV) clear viremia. Factors associated with resolution of viremia are not well defined. Implementation of routine nucleic acid testing (NAT) of blood donors has yielded a large data set for analysis of demographic correlates of resolved viremia. STUDY DESIGN AND METHODS: HCV antibody and NAT data, liver enzyme (alanine aminotransferase [ALT]) results, and donor demographic characteristics were compiled for 2,579,290 allogeneic donations given at five large blood centers after NAT implementation in 1999 through December 2001. Donation HCV RNA status was compared between first-time donors categorized by ALT levels, sex, age, race and/or ethnicity, country of birth, level of education, blood center location, and blood group, with chi-square tests and multivariable logistic regression methods. RESULTS: Of 35 confirmed-seropositive repeat donors, 19 (54.3%) tested negative for the presence of HCV RNA; there was no association between RNA status and preseroconversion intervals (p = 0.74). Of 2105 RIBA-positive, first-time donors, 402 (19.1%) tested negative for the presence of HCV RNA by NAT (presumptive resolved infections). There were significant differences in the frequency of RNA negativity among first-time donors categorized by ALT levels and by race and/or ethnicity. ALT levels were more likely to be elevated in RNA-positive, first-time donors (p < 0.0001). Viremia was less likely to resolve in Asian (8.2%) and black non-Hispanic (14.4%) donors than in white non-Hispanic (20.7%), Hispanic (22.1%), and other race and/or ethnicity (22.1%) donors (p = 0.02). No significant associations were found for age, sex, country of origin, level of education, blood type, and donor center location. CONCLUSION: These results confirm that the frequency of HCV RNA negativity among seropositive persons differs by race and/or ethnicity. Follow-up studies of donors with resolved viremia are warranted to further elucidate viral, immunologic, and genetic factors underlying spontaneous viral clearance.     

A method for estimating incidence rate of infectious diseases among first-time blood donors

BACKGROUND: In certain circumstances, there is no method for estimating incidence based on testing results on a single blood sample from first‐time blood donors, severely limiting the ability to assess the residual risk of blood‐borne infections among this donor subpopulation. STUDY DESIGN AND METHODS: Incidence rates were estimated for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) among first‐time donors using the formula (P₂ ? P₁)/D, where P₁ is the prevalence among blood donations from first‐time donors of the minimum eligible ages for donation, P₂ is the prevalence among donations from first‐time donors of an older age group, and D is the age difference (in years) between the older and younger donor groups. RESULTS: Estimating incidence among first‐time donors using the proposed method based on a single test for anti‐HCV produced similar results to those based on HCV nucleic acid test (NAT) yield cases, by sex and in different periods. Comparison of the proposed method with HIV NAT yield also showed similar results although the small number of HIV NAT yield cases limits interpretation. CONCLUSIONS: The proposed method provides an alternative way for estimating incidence of certain blood‐borne infections among first‐time donors, provided that our assumptions are met. It helps residual risk assessment in donor populations where first‐time donors account for most of the donations and only one test result is available for each donor.     

Prevalence of viral markers among first-time Arab blood donors in Kuwait

BACKGROUND: The aim of this study was to assess the effect of blood donation modes on the prevalence of viral markers among Arab first-time blood donors in Kuwait. STUDY DESIGN AND METHODS: Donor ethnic background was classified as Kuwaiti nationals and non-Kuwaiti Arabs. A total of 26,874 donors were screened in 2002 for the following viral markers: hepatitis C virus antibody (anti-HCV), hepatitis B surface antigen (HBsAg), anti-hepatitis B core antigen (HBc), human immunodeficiency virus-1 and -2 antibody (anti-HIV-1 and -2), HIV p24, and human T lymphotropic virus-I and -II antibody (anti-HTLVI/II). All samples positive for the presence of anti-HBc were tested for anti-HBs. Among these donors, 12,798 were first-time donors of which 74 percent were replacement and 26 percent were volunteers. RESULTS: The prevalence of HCV among replacement donors was significantly higher than the volunteer group. The difference between the two modes of blood donations, however, was not significant for HBsAg. The prevalence of anti-HCV among Kuwaiti national and non-Kuwaiti Arab first-time donors was 0.8 and 5.4 percent, respectively, whereas the prevalence of HBsAg was 1.1 and 3.5 percent, respectively, with the difference being significant at a p level of <0.0001. The difference observed for prevalence of anti-HBc among Kuwaiti national and non-Kuwaiti Arab donors (17 and 33.3%, respectively) was significant (p < 0.0001). Among first-time donors, 13.7 percent were positive for the presence of anti-HBs, indicating that 13.7 percent of the total Arab donor population might have had a previous infection and possible immunity to hepatitis B virus (HBV). CONCLUSION: A high prevalence of HBV and HCV was found among non-Kuwaiti Arab donors. The prevalence of anti-HCV was only significantly higher among replacement versus volunteer first-time donors. Therefore, there is a need to develop a strategic plan that incorporates the diverse background of the blood donors living in Kuwait.