Trends in hepatitis B virus infection among blood donors in Kelantan, Malaysia: a retrospective study

The objective of this study was to determine the prevalence and trends in hepatitis B infection among blood donors attending the Transfusion Medicine Unit at the Hospital Universiti Sains Malaysia, Kelantan, Malaysia. A retrospective study was carried out by reviewing the results of HBsAg among blood donors for the years 2000 to 2004. During this period, 44,658 blood donors were studied. We noted that there was a significant difference in the prevalence of hepatitis B infection between regular and first time donors. There was also a decreasing trend noticed in both study groups. The mean prevalence was significantly different between first time (1.83%) and regular donors (0.45%) (p < 0.005). There is a need to improve public awareness programs to lower the incidence of hepatitis B infection in the general population and consequently first time blood donors. Future studies are also required to determine the trends and outcomes of these programs.     

唐山地区献血人群隐匿性乙型肝炎病毒感染分析

目的了解唐山地区无偿献血人群隐匿性乙型肝炎感染情况。方法用ELISA法检测无偿献血者的乙型肝炎血清标志物,对于HBsAg阴性样本,进行HBV核酸检测（NAT）,NAT阳性样本,用罗氏试剂确证HBV DNA载量。结果共检测116 741例血样,证实隐匿性乙型肝炎感染者35例,占总献血人数的0.29‰。其中97.1%隐匿性乙型肝炎感染者样本的HBV DNA滴度低于102IU/ml。在HBV DNA阳性人群中,抗-HBc阳性率较高,占81.5%,抗-HBs阳性或乙型肝炎病毒血清标志物全阴性也可检出HBV DNA分别占55.6%和22.9%。结论唐山地区献血人群中血清HBsAg阴性者存在一定比例的隐匿性HBV感染,其HBV病毒载量均较低,核酸检测能够提高HBV感染的检出率。     

Seroprevalence of hepatitis B and C virus infections among Lao blood donors

There have been no previous reports of the prevalence of hepatatis B virus (HBV) and hepatitis C virus (HCV) infections in Lao PDR. From 2003 to 2005, 13,897 first-time blood donors were screened for the presence of hepatitis B surface antigen (HBsAg) and hepatitis C virus antibody (anti-HCV). The seroprevalence of HBsAg positive blood donors was 8.7%. The prevalence among males (9.7%) was higher than in females (6.2%). The prevalence of anti-HCV positive blood donors was 1.1%, with no significant differences between males (1.1%) and females (1.0%). Annual positive rates for HBsAg and anti-HCV during the years 2003 to 2005 did not differ significantly. Lao PDR has a high endemicity of HBV carriers (8.7%). Dual infection with HBV and HCV was 0.12%. For preventing HBV infection, the country introduced DPT-Hepatitis B vaccines into the National Immunization Program in 2001. The large reservoir of HBV and HCV infections will cause an enormous burden of patients with cirrhosis and hepatocellular carcinoma in the future.     

Risk factors for hepatitis C virus infection among blood donors in southern Brazil: a case-control study

Background  

In Brazil, it is estimated that between 2.5 and 4.9% of the general population present anti-hepatitis C virus (HCV) antibodies, which corresponds to as many as 3.9 to 7.6 million chronic carriers. Chronic liver disease is associated with HCV infection in 20% to 58% of the Brazilian patients. The objective of this case-control study was to investigate the risk factors for presence of anti-HCV antibody in blood donors in southern Brazil.     

献血员隐匿性乙型肝炎病毒感染的分子流行病学

目的 了解献血员中隐匿性HBV感染的发生率,从S基因变异角度探讨隐匿性HBV感染可能的分子机制.方法 收集经血站筛查HBsAg阴性的合格献血员血浆594份,ELISA法检测HBV血清学标志物,套式PCR检测血清HBV DNA.对筛查出的隐匿性HBV感染者再次用雅培试剂定量检测HBV血清学标志物,并对其S区进行测序,发现可能与HBV隐匿性感染有关的变异位点.随机收集11例HBsAg阳性的HBV感染者作为阳性对照,对其S区进行测序,比较其与隐匿性HBV感染之间的关系.结果 在594例献血员中有15例为隐匿性HBV感染,隐匿性HBV感染的发生率为2.5％.未发现HBV血清学标志物检测结果与隐匿性HBV感染有相关性.15例隐匿性HBV感染者中有10例进行了S区测序,结果HBV均有不同程度的变异,其中3例在“a”决定簇内出现氨基酸突变,分别为1126T(1例)、T140I(2例).与隐匿性HBV感染者相比,阳性对照在“a”决定簇内仅出现了1例T131N变异.结论 常规检测HBsAg阴性的献血员中存在隐匿性HBV感染,且这些病毒可能存在变异.     

Hepatitis B and hepatitis C virus in Thai blood donors

Hepatitis B virus (HBV) and hepatitis C virus (HCV) are major causes of transfusion-transmitted infection (TTI). In Thailand, the prevalence of HBV infection in new blood donors has decreased gradually from 7.1% in 1988 to 2.6% in 2009. This drastic decline in HBV prevalence is mostly the result of an effective expanded program on immunization (EPI) against HBV; the current coverage rate with HBV vaccine in newborns is more than 98% nation-wide. The prevalence of HCV infection, has decreased at a slower rate due to lack of HCV vaccination. The use of healthy volunteer blood donors and nucleic acid amplification technology (NAT) has also contributed to the steady decrease in rates of HBV and HCV infections. We summarize the current status of the EPI program for preventing HBV and the current strategy of HBV and HCV screening in new blood donors.     

Prevalence of antibodies against hepatitis B virus and hepatitis C virus among blood donors in Lebanon, 1997-2003

The prevalence of hepatitis B virus (HBV) antigens (HBsAg) and antibody to hepatitis C virus (anti-HCV) was determined among 16,084 blood donors (14,993 males; mean age, 31.7 +/- 8.2 years and 1084 females; mean age, 31.4 +/- 8.2 years) in the period 1997-2003. Of the donors screened, 149 were HBsAg positive (0.926%), and 65 were anti-HCV positive (0.404%). There was a steady decline in HBsAg prevalence from 1.56% (1997) to 0.33% (2003) and in anti-HCV from 1.22% (1997) to 0.16% (2003). Females had a higher prevalence of anti-HCV (P = .031) and HBsAg (P = .047). Results obtained are of value in light of the occurrence of HBV and HCV transmission by nonparenteral routes.     

Status and natural course of GB virus C/hepatitis G virus infection among high-risk groups and volunteer blood donors in Taiwan

BACKGROUND: Hemophilia, thalassemia and uremia patients are at risk of parenterally transmitted infectious agents. The status and nature of the course of GB virus C/hepatitis G virus (GBV-C/HGV) infection among these groups and blood donors in Taiwan was investigated. METHODS: Serum GBV-C HGV-RNA and antibodies to GBV-C/HGV envelope-2-protein (anti-E2) were determined in 500 blood donors and in 44 hemophilia, 37 thalassemia and 85 uremia patients. Phylogenetic analysis was performed. RESULTS: The prevalence of GBV-C/HGV-RNA and anti-E2, respectively, was 38.6 and 27.3% in hemophilia patients, 27.0 and 27.3% in thalassemia patients, 14.1 and 10.6% in uremia patients and 3.4 and 7.2% in blood donors. The prevalence of GBV-C HGV exposure was 59.1 and 51.4% in hemophilia and thalassemia patients, respectively, which was significantly higher than that for uremia patients (22.4%; P < 0.01) and blood donors (10.2%; P < 0.001). The anti-E2 seroconversion rate was 66.7% in blood donors and 47.4, 36.8 and 34.6% in thalassemia, uremia (P < 0.05 compared with blood donors) and hemophilia (P < 0.01 compared with blood donors) patients, respectively. Discrepancies in the prevalence of GBV-C HGV and hepatitis C virus infection were found among the three risk groups. Phylogenetic analysis showed that 51 of 56 GBV-C HGV isolates clustered in group 3; the remaining five were of group 2a. Twelve of 39 viremic patients in the risk groups cleared the virus during the 4 year follow-up period; seven developed concomitant anti-E2 reactivity. CONCLUSIONS: GB virus C hepatitis G virus infection is epidemic among risk groups and GBV-C HGV group 3 is the major strain in Taiwan. In the risk groups, approximately 18% of infections resolve with concomitant anti-E2 seroconversion within 4 years.     

Trends in hepatitis B and hepatitis C seroprevalence among Nepalese blood donors

In Nepal, hepatitis B and hepatitis C are considerable health problems. This study aimed to assess the trends of hepatitis B virus (HBV) and hepatitis C virus (HCV) seroprevalence in blood donors over the last 6 years nationwide and in the urbanized setting of Kathmandu Valley. This was a retrospective study conducted among Nepalese blood donors through the years 2001/2002-2006/2007. Serum samples were tested for hepatitis B surface antigen and anti-HCV antibodies using third generation ELISA tests. The donors' information was collected via the donor record register through their respective Blood Transfusion Services. The software, Winpepi ver 3.8 was used for statistical analysis. The overall seroprevalence rates of HBV and HCV in a nationwide analysis were observed to be 0.82 and 0.47%, respectively, and at Central Blood Transfusion Service (CBTS), Kathmandu, the rates were 0.92 and 0.71%, respectively. The seroprevalence of HBV was significantly higher than the seroprevalence of HCV, both nationwide and at CBTS (P < 0.05). An overall significantly decreasing trend was observed in HBV and HCV seroprevalence both nationwide and at CBTS, Kathmandu, over the last 6 years (P < 0.05). Though the overall trend was significantly decreasing, the test for departure from a linear trend also showed a statistically significant result (P < 0.05).     

HBV/A and HBV/C genotype predominance among patients with chronic hepatitis B virus infection in Cebu City, Philippines

Context  

Chronic Hepatitis B virus (HBV) infection causes significant morbidity and mortality with widespread global distribution. Different genotypes display variations in pathogenesis, disease behavior, and treatment response. HBV/B and HBV/C are prevalent in Asia, but minimal data come from the Philippines.     

Prevalence and genotypes of hepatitis C virus infection among drug addicts and blood donors in Thailand

Hepatitis C virus (HCV) is an infectious agent that has the potential to cause chronic liver disease, cirrhosis and hepatocellular carcinoma. We determined the prevalence and genotypes of HCV infection among groups of drug addicts: intravenous drug users (n = 134), methamphetamine users (n = 100), inhaled-drugs users (n = 19) and alcoholics (n = 50); a group of blood donors acted as a control. The control group consisted of 179 randomly-selected anti-HCV positive samples: these were subjected to HCV RNA screening and genotyping. The anti-HCV test was performed by ELISA: HCV RNA screening was by nested RT-PCR that employed primers from the 5' noncoding region. The genotype assay was based upon analysis of the 5' NCR amplified sequences and RFLP. Hepatitis C virus was highly prevalent among all groups of drug addicts (12-70%). In 2000. among the new blood donors (n = 66,340) at the National Blood Center, Thai Red Cross, anti-HCV prevalence amounted to 0.98%. The HCV genotype distribution showed that the most prevalent genotype was 3a, followed by 1b and 6a. Our data demonstrated the very high prevalence of HCV infection in IVDUs, a finding that is consistent with the blood-borne nature of the virus. In order to curb HCV infection, a determined effort to educate both the general population and high-risk groups is required; such a program of education would address both general and particular methods of transmission, especially the use of non-sterile needles etc.     

Prediction of occult hepatitis B virus infection in liver transplant donors through hepatitis B virus blood markers

Background

Occult hepatitis B virus infection is defined as detectable HBV-DNA in liver of HBsAg-negative individuals, with or without detectable serum HBV-DNA. In deceased liver donors, results of tissue analysis cannot be obtained prior to allocation for liver transplantation.

Aims

we investigated prevalence and predictability of occult hepatitis B using blood markers of viral exposure/infection in deceased liver donors.

Methods

In 50 consecutive HBsAg-negative/anti-HBc-positive and 20 age-matched HBsAg-negative/anti-HBc-negative donors, a nested-PCR assay was employed in liver biopsies for diagnosis of occult hepatitis B according to Taormina criteria. All donors were characterized for plasma HBV-DNA and serum anti-HBs/anti-HBe.

Results

In liver tissue, occult hepatitis B was present in 30/50 anti-HBc-positive (60%) and in 0/20 anti-HBc-negative donors (p < 0.0001). All anti-HBc-positive donors with detectable HBV-DNA in plasma (n = 5) or anti-HBs > 1,000 mIU/mL (n = 5) eventually showed occult infection, i.e, 10/30 occult hepatitis B-positive donors which could have been identified prior to transplantation. In the remaining 40 anti-HBc-positive donors, probability of occult infection was 62% for anti-HBe-positive and/or anti-HBs ≥ 58 mIU/mL; 29% for anti-HBe-negative and anti-HBs < 58 mIU/mL.

Conclusions

In deceased donors, combining anti-HBc with other blood markers of hepatitis B exposure/infection allows to predict occult hepatitis B with certainty and speed in one third of cases. These findings might help refine the allocation of livers from anti-HBc-positive donors.     

Seroprevalence of hepatitis B,hepatitis C and human immunodeficiency virus among blood donors,Phitsanulok Regional Blood Center,Thailand

Human immunodeficiency virus (HIV), hepatitis C virus (HCV) and hepatitis B virus (HBV) infections are important blood-borne infections in many countries including Thailand. For epidemiological surveillance and controlling these infections, a cross-sectional group of 2,167 blood donors were screened for HBsAg, antibodies to HCV and HIV by enzyme immunoassay methods. The results revealed that the prevalence of HBsAg positive among studied blood donors was 4.61%, anti-HCV was 2.90% and anti-HIV was 0.69%. When the prevalence was classified by selected socio-demographic variables, it was found that variables including age, gender, marital status and occupation were significant for HBsAg positive rate (p=0.0068, p=0.0019, p=0.0048 and p=0.0017, respectively). For anti-HCV prevalence, studied variables including educational level, occupation and domicile were significant (p<0.0001, p=0.0027, and p<0.0001, respectively), while only educational level was a significant variable for anti-HIV prevalence (p=0.0021). These findings suggest that we should present integrated information and educational programs for preventing and controlling HBV, HCV and HIV transmission among this target group.     

Serum alanine aminotransferase level in relation to hepatitis B and C virus infections among blood donors

Abstract: To assess the serum alanine aminotransferase (ALT) activity in relation to hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among blood donors, antibodies to HCV (anti-HCV) and hepatitis B surface antigen (HBsAg) were detected in 400 blood donors with normal ALT level (≤750 μmol/s per liter), and 76 blood donors with raised ALT level. The prevalence of anti-HCV (10.5%) and HBsAg (28.9%) in the latter was higher than that (2.0% and 17.5%, respectively) in the former (p<0.001 and p<0.03, respectively). There was a trend that indicated that the risk of anti-HCV positivity increased with increasing age (p<0.001). Thirty of 76 (39.5%) donors with raised ALT level were positive for anti-HCV or HBsAg. Compared with HBsAg-positive donors, donors with anti-HCV had higher serum ALT levels (p<0.01) and greater mean age (p<0.01). Multivariate analysis indicated that both anti-HCV (odds ratio: 6.2; 95% confidence interval: 2.2–17.8) and HBsAg (odds ratio: 2.2; 95% confidence interval: 1.3–3.9) were significantly associated with raised serum ALT activity. The estimated population-attributable risk was 8.6% for anti-HCV, and 13.8% for HBsAg. In conclusion, although HBV and HCV infections are independent risk factors of raised ALT activity among blood donors, they play a minor role in the etiology of raised ALT activity.     

Epidemiologic study of chronic hepatitis B virus infection in male volunteer blood donors in Karachi,Pakistan

Background  

The magnitude of chronic infection with hepatitis B virus (HBV) varies substantially between the countries. A better understanding of incidence and/ or prevalence of HBV infection and associated risk factors provides insight into the transmission of this infection in the community. The purpose of this investigation was to estimate the prevalence of and to identify the risk factors associated with chronic infection with HBV, as assessed by HBV surface antigen (HBsAg) positivity, in asymptomatic volunteer male blood donors in Karachi, Pakistan.     

Prevalence and trends of markers of hepatitis C virus, hepatitis B virus and human immunodeficiency virus in Delhi blood donors: a hospital based study

Transfusion transmitted infections (TTIs) are a major problem associated with blood transfusion practices. A 4-year retrospective study from 2002 to 2005 was conducted at the blood bank of Lady Hardinge Medical College and associated hospitals in New Delhi, India. Donors were evaluated for the prevalence of HCV, HBsAg and HIV. A total of 28,956 healthy blood donors were tested, out of which 28,805 (99.48%) were replacement donors and 151 (0.52%) were voluntary donors. The proportion of voluntary donors was significantly low (P<0.001). Males formed the bulk of the donor population (97.24%). The prevalence of HCV, HIV and HBsAg was 0.66% (ranging from 1.01% in 2002 to 0.29% in 2005), 0.56% (ranging from 0.70% in 2002 to 0.44% in 2005) and 2.23% (ranging from 2.42% in 2002 to 1.97% in 2005), respectively. For all three major TTIs, we found a decreasing trend in the prevalence over the past 4 years. The decreasing trend of HCV prevalence was significant (P<0.001), but the same was not true for HIV and HBsAg. We suggest the need to stress more stringent donor selection criteria with emphasis on non-remunerated voluntary donations to ensure a safer blood supply.