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ORIGINAL ARTICLE
Year : 2015  |  Volume : 6  |  Issue : 2  |  Page : 142-146

Seronegativity HBsAg, HCV and HIV among blood donors: A five year study


1 Department of Pathology, C. U. Shah Medical College, Surendranagar, Gujarat, India
2 Department of Microbiology, C. U. Shah Medical College, Surendranagar, Gujarat, India

Date of Web Publication13-Jul-2015

Correspondence Address:
Dr. Atul V Shrivastav
Department of Pathology, C. U. Shah Medical College, Dudhrej Road, Surendranagar, Gujarat - 363 001
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0975-9727.160686

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  Abstract 

Introduction: This study is conducted to evaluate the seroprevalance of HIV, HBsAG, HBV and syphilis among blood donors at blood bank of medical college hospital along the five years. Material and methods: Study includes both voluntary and replacement donors. HIV, HBsAG and HCV were tested by ELISA methods approved by NACO and RPR was carried out for screening of Syphilis. Results: The seroprevalance of HIV, HBsAG, HCV and Syphilis was 0.08%, 0.3%, 0.07% and 0.17% respectively in voluntary blood donors while seroprevalance of HIV, HBsAG , HCV and Syphilis was 0.31%, 1.18%, 0.16% and 1.12% respectively in replacement blood donors. Conclusion: We observe that seroprevalance is higher in replacement donors than voluntary donors. These facts strongly indicate that we need more motivational and educational programmes to shift complete voluntary donation.

Keywords: Seroprevalance, voluntary blood donors, replacement donors


How to cite this article:
Bodarya O, Shrivastav AV, Bhavsar U, Ramanuj A, Joshi JR, Agnihotri AS. Seronegativity HBsAg, HCV and HIV among blood donors: A five year study. Muller J Med Sci Res 2015;6:142-6

How to cite this URL:
Bodarya O, Shrivastav AV, Bhavsar U, Ramanuj A, Joshi JR, Agnihotri AS. Seronegativity HBsAg, HCV and HIV among blood donors: A five year study. Muller J Med Sci Res [serial online] 2015 [cited 2020 Jul 10];6:142-6. Available from: http://www.mjmsr.net/text.asp?2015/6/2/142/160686


  Introduction Top


Human Blood is scarce and very precious for saving lives of patients. Transmission of infectious diseases through donated blood is of concern in order to provide safe blood for transfusion which forms an integral part of medical and surgical therapy. Human blood is an essential therapeutic procedure, as there is no genuine substitution. Even though it can save human lives, in some instances it can transmit infectious diseases, which are fatal. Blood transfusion carries the risk of transfusion transmissible infections (TTI) including HIV, hepatitis, syphilis, malaria and less frequently toxoplasmosis,  Brucellosis More Details and some viral infections like Epstein-Barr virus, cytomegalovirus and herpes. [1] With every unit of blood, there is 1% chance of transfusion-associated problems including transfusion-transmitted Diseases. [2]

The improved screening and testing of blood donors has significantly reduced transfusion transmitted diseases in most developed countries. This has not been so in developing nations. Poor health education and lack of awareness result in the reservoir of infections in the population. The incidence of transfusion-transmitted HIV and hepatitis is increasing in India. [3] The aim of the present study was to know the seroprevalence of transfusion-transmitted diseases in donors in our Saurashtra region of Gujarat state.


  Materials and Methods Top


We included five consecutive years in our study to identify the trend of increase or decrease among these diseases. Tests are routinely done on every blood unit to exclude HIV, HBV, HCV and syphilis. Data were collected for a period 5 years from SEP-2008 to AUG-2013. During this period 24,335 donors were tested. Blood was collected from healthy donors as criteria set by WHO. [4]

The screening for HIV was done by ELISA (J. Mitra Pvt. Ltd., India), HBsAg (Span Diagnostics (SD), India) was detected by ELISA, Anti-HCV (Span Diagnostics (SD), India) test was done by ELISA. Test for Syphilis was done by RPR method (ASPEN, India). All the reactive samples were repeated in duplicate. Repeat reactive were labelled as ELISA positive for respective infection and were discarded. Prior permission to perform this study was taken from our institutional ethical committee.


  Result and Observation Top


A total of 24,335 units of blood were collected during the period of 01-09-2008 to 31-08-2013. [Table 1] shows age wise distribution of male (vol. and rep.) and female donors (vol. and rep.). [Table 2] shows age year and gender wise distribution of seropositive donors. [Table 3] shows age wise distribution of seropositive donors. [Table 4] and [Table 5] shows seropositivity of voluntary and replacement donors respectively. [Table 6] shows comparison of various studies carried out in various parts of India. [Figure 1] shows graphical representation of year wise seropositivity in voluntary donors. All results are analysed by chi square test and were found satisfactory.
Figure 1: Bar Diagram of year wise Seropositivity in Voluantry Donors

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Table 1: Age wise distribution of male (vol. and rep.) and female donors (vol. and rep.)

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Table 2: Year and gender wise distribution of seropositive donors

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Table 3: Age wise distribution of seropositive donors

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Table 4: Seropositivity in voluntary donors

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Table 5: Year wise seropositivity in replacement donors

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Table 6: Comparison of various studies with present study

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  Discussion Top


Infection with HBV, HCV, HIV and syphilis (TTI) is worldwide significant problem in public health. They are also much more problematic in India. So, it is necessary to measure how much they are spread in our country. In a vast country like India, a survey of blood transmissible diseases in the country as a whole is very difficult. Individual epidemiological surveys of each state may help us to understand the seriousness of the problem and the changing trends. So, we deed this study in our part of western India.

In general, the diagnosis of HBV, HCV, HIV and syphilis is based on the presence of the corresponding antigens or antibodies in blood serum. [5] It is very important to take care about sex and age distribution of these infections.

Viral hepatitis B and hepatitis C are significant global health issues for industrialized and developing countries. It is estimated that there are 2 billion people who have been exposed to hepatitis B worldwide, with 350 million suffering from chronic infection. The statistics for hepatitis C are hardly better, it is estimated that there are more than 200 million people who are chronically infected throughout the world. Hepatitis B is estimated to result in 563,000 deaths annually versus 366,000 deaths for hepatitis C. HBV and HCV are major causes of chronic liver diseases worldwide, especially cirrhosis and hepatocellular carcinoma. [6] According to the WHO, the world prevalence with HCV is about 3 %. [7]

In our study, prevalence of HBsAG and HCV is more amongst male replacement donors which is statistically significant and age of donors is young age (<30 years). It is less prevalent amongst female donors. As compare to other study which was based on age and sex of donors shows that HBsAG infection is more common in male donors with age of >30 years. [8] [Table 6] shows HBsAg is more prevalent in southern part of India. [9] It may be due to the frequency of HBsAg is more than other infectious diseases because of asymptomatic carriers. In our study, prevalence of HbsAg is less, it may be because of more awareness of donors and stringent screening. HCV is more at Northern part (Ludhiana). [10] Prevalence of HCV is almost same in Northern [11] and Western part of Gujarat. It may be because of same type of kits used during testing.

HIV is most dangerous TTI in our world because it has shows increasing trend in various studies and once it entered into body there is no other way to protect ourselves from it. It is dead end of our lives because there is no treatment of HIV. People living with HIV/AIDS in 2010 are around 34 million, already; more than 30 million people around the world have died of AIDS-related diseases. In 2010, 2.7 million people were newly infected with HIV, and 1.8 million men, women and children died of AIDS related causes. [12]

In our study, prevalence of HIV is more prevalent amongst male replacement donors with age <30 years. Here, we find out prevalence of HIV in western part of India is 0.16% and it is same as study conducted in Northern Gujarat (0.16%). Southern part of India has more prevalent of HIV than any other part (0.91%). [9] It may be due to more accurate pretransfusion testing of donor's blood.

Treponema pallidum, the causative agent of syphilis and it is one of the oldest recognized infections. Risk of transmission is greatly reduced by storing blood for 48-72 h at 6 ° C. Despite the loss of viability of  Treponema pallidum Scientific Name Search  refrigerated blood, a positive RPR test requires that the blood be discarded, since such donors are at risk of other sexually transmitted agents. [13]

In our study, syphilis is more prevalent amongst male replacement donors and age of donors is >30 years. In our study, we have found out 0.52% prevalence and it is also more prevalent in northern part of India (South Haryana [1] and Ludhiana). [9] It may be due to unawareness about disease amongst donors and less stringent screening.

Our study which is carried out in western part of India shows HIV0.16%, HBsAg0.6%, HCV0.1% SYPHILIS 0.52%. As compared to other study our study show declining trend of TTI in western part of India.

The declining trends in seroprevalence of TTI in the blood donors is a good signal as the risk of acquiring infections due to transfusion is decreased. This declining trend may be due to more public awareness about the disease, the use of newer generation kits with improvements in specificity and sensitivity of blood-borne pathogen detection and larger sample size due to increased donors' recruitment efforts leading to more accurate results.

Most of the donors, who were recruited in this study, came from public awareness. It was to be noted that maximum number of donors came from age group 18-30 years. It may reflect proper awareness among the young population about blood donation. Percentages of female donors have been low all the years. Similar trend has been noted in earlier reports also.

Study by Abdullah et al. [14] highlight the importance of investing in awareness and motivational campaigns among university students and youth in general that aim to correct misconceptions about blood donation and address issues that will increase donor flow. Efforts should be made to improve the numbers of female donors. More awareness among female population by holding camps in women's colleges, training and recruiting more female stuffs and an improvement in privacy of these blood camps should be done to encourage more females to donate blood. Apart from recruiting new donors, measures should be taken to retain previous donors. Comparison of various studies has been given in [Table 6]. So, we can get data of prevalence from various part of India. [11],[15],[16],[17],[18]

In our study, there is more prevalence of TTI in replacement donors as compared to voluntary donors. It may be due to voluntary donors are aware of TTI and remuneration or inducements are not given to them as a part of donation. Whereas replacement donors are under the influence of getting remuneration or inducement from patient's relative. It is necessary to aware all type of donors about TTI by means of media, examples or by promoting self-respect of saving lives of other people.

 
  References Top

1.
Arora D, Arora B, Khetarpal A. Seroprevalence of HIV, HBV, HCV and syphilis in blood donors in Southern Haryana. Indian J Pathol Microbial 2010;53:308-9.   Back to cited text no. 1
    
2.
Pawle J, Biradar SS, Domble VD. Seroepidemology of HIv, HBV, HCV infections among blood donors in Bagalkot district - A cross sectional study. Medical innovatica 2013;2:8-10  Back to cited text no. 2
    
3.
Rose D, Sudarsanam A, Padankatti T, Babu PG, John TJ. Increasing prevalence of HIV antibody among blood donors monitored over 9 years in one blood bank. Indian J Med Res 1998;108:42-4.  Back to cited text no. 3
    
4.
Blood Donor Selection- Guidelines on assessing donor suitability for blood donation. Available from: http://www.who.int/bloodsafty/publications/BD selection.pdf. [Last assessed 2014 May on 5].  Back to cited text no. 4
    
5.
Bhattacharya P, Chandra PK, Datta S, Banerjee A, Chakraborty S, Rajendran K, et al. Significant increase in HBV, HCV, HIV and syphilis infections among donors in West Bengal, Eastern India 2004-2005: Exploratory screening reveals high frequency of occult HBV infection. World J Gastroenterol 2007;13:3730-3.  Back to cited text no. 5
    
6.
Voiculescu M, Iliescu L, Ionescu C, Micu L, Ismail G, Zilisteanu D, et al. A cross-sectional epidemiological study of HBV, HCV, HDV and HEV prevalence in the SubCarpathian and South-Eastern regions of Romania. J Gastrointestin Liver Dis 2010;19:43-8.  Back to cited text no. 6
    
7.
WHO (1999) Hepatitis C global prevalence. Weekly Epidemiological Record. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1415844/. [Last assessed on 2014 May 5].  Back to cited text no. 7
    
8.
Sinha SK, Roychoudhury S, Biswas K, Biswas P, Bandopadhyay R. Prevalence of HIV, Hepatitis B, Hepatitis C and Syphilis in donor′s blood: A study from eastern part of India. Open J Hemat, 2012;3:1-6.  Back to cited text no. 8
    
9.
Kulkarni N. Analysis of the seroprevalence of HIV, HBsAg, HCV and syphilitic infections detected in the pretranfusion blood: A short report. A short report. IJBTI 2012;2:13.   Back to cited text no. 9
    
10.
Gupta N, Kumar V, Kaur A. Seroprevalence of HIV, HBV, HCV and syphilis in voluntary blood donors. Indian J Med Sci 2004;58:255-7.  Back to cited text no. 10
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11.
Shah N, Shah JM, Jhaveri P, Patel K, Shah CK, Shah NR. Sero prevalence of HBV, HCV, HIV and syphilis among blood donors at a tertiary Care Teaching Hospital in Western India. GMJ 2013;68:35-9.  Back to cited text no. 11
    
12.
Patton GC, Coffey C, Sawyer SM, Viner RM, Haller DM, Bose K, et al. Global patterns of mortality in young people: A systematic analysis of population health data. Lancet 2009;374:881-92.  Back to cited text no. 12
    
13.
Kocak N, Hepgul S, Ozbayburtlu S, Altunay H, Ozsoy MF, Kosan E, et al. Trends in major transfusion-transmissible infections among blood donors over 17 years in Istanbul, Turkey. J Int Med Res 2004;32:671-5.  Back to cited text no. 13
    
14.
Al-Faris AK, Bahabri AS, Al-Aqeel AA, Al-Momi MS. Attitude to blood donation among male students at King Saud University. J Appl Hematol 2013;4:70-7.  Back to cited text no. 14
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Chandra T, Kumar A, Gupta A. Prevalence of transfusion transmitted infections in blood donors: An Indian experience. Trop Doct 2009;39:152-4.  Back to cited text no. 15
    
16.
Pallavi P, Ganesh CK, Jayashree K, Manjunath GV. Seroprevalence and trends in transfusion transmitted infections among blood donors in a university hospital blood bank: A 5 year study. Indian J Hematol Blood Transfus 2011;27:1-6.  Back to cited text no. 16
    
17.
Das BK, Gayen BK, Aditya S, Chakrovorty SK, Datta PK, Joseph A. Seroprevalence of Hepatitis B, Hepatitis C, and human immunodeficiency virus among healthy voluntary first-time blood donors in Kolkata. Ann Trop Med Public Health 2011;4:86-90.  Back to cited text no. 17
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Pathak S, Chandrashekhar M. Transfusion transmittable infections - Seroprevalence among blood donors in a tertiary care hospital of Delhi. Asian J Transfus Sci 2013;7:116-8.  Back to cited text no. 18
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    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]


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