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Indian Journal of Transfusion Medicine
  Indian Journal of Transfusion Medicine Indian Journal of Transfusion Medicine

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Seroprevalence of hepatitis C antibodies in healthy blood donors

                                                                                                                                                         Dr. Surabhi Tyagi

                                                                                                                                                         Email: dr_tyagi_surabhi@yahoo.co.in

 

Abstract – blood transfusion is an effective mode of transmission of hepatitis C infection. In developed countries various measures have been taken to reduce the spread of infection through this route. In India, mandatory screening for HCV was introduced as late as 2002.It was started in japan & US in 1990. The studies all over India suggest that despite testing of blood units,HCV infection is still a significant problem.

HCV is  transmitted by blood to blood contact.in developed countries.About 90 % of persons with chronic HCV were infected through transfusion of unscreened blood or blood products or via I/V drug abuse or sexual exposure.

In developing countries, the primary sources of HCV infection are unsterilized injection equipment & infusion of screened blood & blood products.

The present study was conducted to determineseroprevalence of hepatitis C in 6000 donors in greater Noida. The screening was done by ELISA( third generation microelisa kit.)

Seroprevalence of anti HCV in 6000 donors was 1.28 % with the prevalence of 1.34 % in voluntary & of 1.28% in replacement donors.

Males show higher incidence of 1.29% & females 0.66 %.

Blood group B negative showed higher positivity (1.886%) followed by A positive (1.408%) closely followed by O positive (1.4008%).

Age group >51 yrs show positivity of 5.405% followed by age group of 31-40 yrs ( 1.745%)

Key words – HCV -  hepatitis C virus, seroprevalence , blood donors, ELISA.

Introduction - Hepatitis C, an emerging infection in India, was first detected in 1989 using molecular biology techniques after extensive testing of serum from experimentally infected animals ( Choo etal 1989) .

It was later characterized to be an RNA virus that belongs to the flavi-viridae family & genus hepaci virus. Ever since its discovery, it became clear that it was a major cause of acute hepatitis after blood transfusion.It’s association with hepatocellular carcinoma underscores its public health importance.

Blood transfusion is an effective mode of transmission of HCV. After introduction of compulsory blood screening ,its incidence has dropped.

Intravenous & percutaneous drug usage is also an emerging important concern.

Renal transplant patients, patients on hemodialysis ,health care workers,jail inmates,kalaazar patients in endemic areas are also at high risk.

STD’s & HCV are expected to go hand in hand due to their similar modes of transmission.

Material & methods –

The present study was conducted on 6000 blood donors in the school of medical sciences & research,Shardauniversity,greaternoida.

The HCV antibodies were tested by ELISA technique using third generation HCV microelisakit supplied by J.Mitra&Co.Ltd.

The seropositive samples were again tested on ELISA kits of RFCL &/or BIORAD for further confirmation & ruling out any false positive or false negative results.


Observations –

In the present study, anti HCV positivity among 6000 blood donors was 1.28% ( 77/6000).

Seroprevalence in voluntary donors was 1.34 %  ( 4/297)

Seroprevalence in replacement donors was 1.28 % ( 73/5703)

Following tables show distribution of anti HCV positive blood donors based on age, sex, blood groups in this study

Distribution of anti –HCV positive blood donors based on sex

                                   Voluntary                                         Replacement 

Sex

 

  Total donors

Anti – HCV positive

Total donors

Anti-HCV positive

Total %

Male

 

   269

  04

5581

72

1.29%

Female

 

     28

  00

  122

01

0.66%

 

Total

 

   297

  04

5703

73

1.28%

Distribution of anti –HCV positive blood donors based on blood groups

    Blood group

 

Total blood donors

Anti –HCV positive

 Total %

 

   A  positive

 

1349

 

      19

 

1.408

 

   A negative

 

   93

 

      00

 

     00

 

   B  positive

 

1964

 

      24

 

1.221

 

   B  negative

 

  159

 

      03

 

1.886

 

   O  positive

 

1856

 

      26

 

1.4008

 

   O  negative

 

  125

 

      01

 

0.800

 

  AB  positive

 

429

 

      04

 

0.9324

 

  AB  negative

 

  25

 

     00

 

      00

 

   Total

 

6000

 

     77

 

Distribution of anti –HCV positive blood donors based on age  

                           Voluntary                                                                   Replacement

Age (yrs)

Total no.of cases

 

   %

No. of positive cases

 

   %

Total no.of cases

 

 %

No. of positive cases

 

   %

% of total positive cases

 

 ≤ 20

 

 

  43

 

14.47

 

    -

 

-           

 

  480

 

8.41

 

  04

 

0.833

 

0.764

 

21  -30

 

 

129

 

43.43

 

   02

 

   1.55

 

3353

 

58.79

 

37

 

1.103

 

1.120

 

31-40

 

 

   93

 

31.31

 

   02

 

   2.150

 

1511

 

26.49

 

  26

 

1.720

 

1.745

 

41 – 50

 

 

   26

 

8.75

 

   -

 

    -

 

  328

 

5.75

 

  04

 

1.219

 

1.299

 

 ≥ 51

 

 

   06

 

2.02

 

   -

 

-           

 

    31

 

0.54

 

  02

 

6.451

 

5.405

 

Total

 

 297

 

 

 

   04

 

 

5703

 

 

 73

 

 

Discussion –

It is well documented that HCV is transmitted through blood. Main mode of infection is transfusion of unscreened blood or blood products, drugs, sexual exposure.

There are many studies all over the world indicating different prevalence rates of HCV antibody in blood donors.

Seroprevalence of Hepatitis C in blood donors in India

 

State

 

   Year

 

 

 % HCV

 

 Author

 

North India

 

1992

 

2.50

 

Sood et al

 

North India

 

1993

 

2.20

 

Narang et al

 

Delhi

 

1995

 

1.5

 

Irshad et al

 

Delhi

 

1997

 

1.85

 

Panigrahi et al

 

Delhi

 

1999

 

0.53

 

Makroo et al

 

Delhi

 

1999

 

1.57

 

Jain et al

 

Delhi

 

1999

 

0.5

 

Singh et al

 

Ludhiana

 

2001

 

0.7

 

Kaur  et al

 

Ludhiana

 

2001

 

1.50

 

Gupta &kaur

 

Patiala

 

2003

 

0.88

 

Permeet et al

 

Punjab

 

2004

 

1.09

 

Gupta  et al

In the present study prevalence of anti –HCV was 77 ( 1.28 % ) out of 6000 blood donors.

This is in accordance with the previous studies in and around NCR.

Seroprevalence in voluntary donors is slightly higher ( 1.34% ) than in replacement donors  ( 1.28%) .this may be due to the awareness of free screening facility associated with blood donation.


Males show higher incidence of ( 1.29%) than females ( 0.66 %) .

Makroo et al (1996) &Patino – Sarcinelli et al, 1994, concluded from their study that HCV seropositivity was strongly associated with male sex.

 

Maximum anti –HCV seropositivity was seen in donors belonging to ≥ 51 yrs ( 5.405%) , followed by 31- 40 yrs age group ( 1.745 % ).

With increasing age, anti – HCV positivity was found to increase significantly. Similar observations were made by Sirchia et al ( 1989 ) &Patino- Sarcinelli et al ( 1994)

It was also observed that blood group B negative showed higher positivity ( 1.886%) followed by A positive (1.408%), closely followed by O positive ( 1.4008%).

Only one study was available for comparison. Permeet et al (2003 ) Patiala, which shows increased prevalence in blood group O. Difference may be due to regional variation.

However, no other earlier reports could be traced to access the preferential preference,if any, of HCV to any blood group.

Conclusion

Hepatitis C is an emerging infection in India whose long term implications will be dealt with in the decades to come.

As the incidence of post transfusion hepatitis C infection decreases considerably after screening the blood for anti –HCV,it should be a mandatory routine.

Though, the cases in their “window period” escape detection still, the risk is reduced considerably.

Stringent blood banking laws & public awareness to donate blood repeatedly & restrain based on self deferral are important.

References –

  1.  MakrooRN,RainaV,KaushikV.Prevalence of hepatitis C virus antibody in healthy blood donors. Indian J Med Res 1999 ;110:123-5
  2. AzeneDessieBayeshAbera,Fissehawale,Seroprevalence of major blood borne infections among blood donors at FelegeHiwot referral hospital ,Northwest Ethopia.Ethiop J health dev 2007:21(1):68-69
  3. SirchiaG,Bellobuono A, Giovonetti A et al . Antibodies to hepatitis C virus in Italian blood donors,Lancet 1989:797
  4. Agarwal SK, Dash S C and Irshad M 1999 Hepatitis C virus infection during haemodialysis in India; J Assoc.Physicians India 47 1139 – 1143
  5. Amrapurkar DDM, KripalaniA,Amrapurkar A, Kankonkar S 2001 Prevalence of hepatitis C genotypes in Indian patients ;J.Assoc. Physicians India 49 983-985
  6. Chandra M,Khaja M N ,FareesN,PoduriCD,HussainMM,AejazHabeeb M and Habibullah M 2003 Prevalence ,risk factors and genotype distribution of HCV and HBV infection in the tribal population: a community based study in south India; Trop.gastroenterol. 24 193-195
  7. GosaviMS,ShahSK,Shah SR etal. Prevalence of hepatitis C virus infection in Mumbai. Indian J Med Sci 1997;51(10):378-85
  8. MachaveYV,DhotPS.Prevalence of Hepatitis C virus antibody in heterogenous population of blood donors.MedJr.Armed forces India 1999;55:313-4
  9. PermeetkaurBagga,SPSingh.Seroprevalence of hepatitis C antibodies in healthy blood donors –a prospective study.Ind J pathol and microbial 2007:vol 50(2);429-32
  10. Lt.Col A Chattoraj,Col R Bhel,Brig VK Kataria.Infectious disease markers in blood donors.MJAFI:2008:Vol64(1);33-35

 

 

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Dr. SURABHI TYAGI
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