Dr. Surabhi Tyagi MD(Pathology)
ORIGINAL ARTICLE
Seroprevalence of hepatitis C antibodies inhealthy blood donors
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.
Materials & 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.
Observation -
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.
Address for correspondence –
Dr.SurabhiTyagi
207,old staff quarters
Sharda hospital campus
Shardauniversity
Greater Noida,U.P.
India
Email: dr_tyagi_surabhi@yahoo.co.in
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