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Indian Journal of Community Medicine

Prevalence of Hepatitis C Antibodies in Healthy Blood Donors

Author(s): Nalini Gupta, Amarjit Kaur

Vol. 27, No. 1 (2002-01 - 2002-03)

Deptt. of Transfusion Medicine, Dayanand Medical College & Hospital, Ludhiana

Abstract:

Research question: What is the prevalence of hepatitis C virus infection in healthy blood donors?

Objective: To screen the blood donors for HCV antibodies routinely.

Study design: Cross-sectional.

Setting: Deptt. of Transfusion Medicine, Dayanand Medical College & Hospital, Ludhiana.

Participants: Healthy blood donors.

Statistical analysis: Prevalence rate.

Results: Prevalence of anti HCV was found to be 1.5% which is quite high.

Keywords: HCV antibodies, Healthy blood donors

Introduction:

Hepatitis C virus (HCV), the main etiological agent of the clinical entity formerly known as Non-A, Non-B Hepatitis, was discovered in 1989 by group of collaborating scientists from Chiron and the Centres for Diseases Control 1 . With the screening of all the donated blood units for HbsAg being made mandatory, incidence of post transfusion hepatitis (PTH) due to HBV has reduced considerably all over the world. Proper pre-donation screening of donors and rejecting volunteers with a past history of viral hepatitis also helped in lowering the incidence of PTH. However, still hepatitis C virus is an important cause of PTH. The present study was undertaken to find out the prevalence of Hepatitis C antibodies in healthy blood donors in northern India.

Material and Methods:

A total of 21014 healthy blood donors were screened for HCV antibodies. There was no history of jaundice in these donors. Out of these, 19835 (94.4%) were replacement donors and 1179 (5.6%) were voluntary donors. No honorary and professional donor was bled. The sera of these blood units were tested by a fully automated microplate elisa processor (ARIO model) from SEAC RADIM Group. The commercially available kits from Ortho HCV 3.0 Elisa test system with enhanced SAVe (sample addition verification) for detection of antibodies to HCV were used. Only those samples, which were reactive on repeated examinations were considered positive. Prevalence of HCV antibody positivity in donors was compared with the data from the previous studies in India and other countries.

Results:

Table I: Blood units collected and reactivity to anti HCV.

Blood units collected Anti HCV
  Replacement Voluntary Total Reactive
Number 19,835 1,179 21,014 321
Percentage 94.4 5.6 100 1.5

Out of 21014 donors screened, 19,835 (94.4%) were replacement donors and 1,179 (5.6%) were voluntary donors. Out of total 21,014 donors, 321 (1.5%) donors were reactive for HCV antibody.

Discussion:

The present study was undertaken to determine the prevalence of HCV antibodies in healthy blood donors. The presence of anti HCV does not constitute a diagnosis of Hepatitis C, but may be indicative of recent and/or past infection by hepatitis C virus. A non-reactive test result does not exclude the possibility of exposure to HCV. Levels of anti HCV may be undetectable in early infections. Even then, screening blood donors for anti HCV has reduced the incidence of post transfusion non-A, non-B hepatitis dramatically. The prevalence rate of anti HCV in different studies is compared in the Table II.

Table II: Showing comparison between present and other studies.

Studies Prevalence rate (%)
Kuhnl et al1989 (German group) 2 0.42
Kuo et al1989 (American group) 3 0.50
Janot et al 1989 (French group) 4 0.68
Sirchia et al 1989 (Italy group) 5 0.87
Esteban et al1989 (Spanish group) 6 1.20
Choo et al 1989 (Japanese group) 7 1.20
Brind et al 1990 (North-East England group) 8 0.18
Sood et al 1992 (Indian group) 9 2.50
Narang et al 1993 (Indian group) 10 2.20
Sumathy et al 1993 (Indian group) 11 11.30
Arnakalle et al 1995 (Indian group) 12 0.12
Chaudhary et al 1995 (Indian group) 13 0.30

Irshad et al 1995 (Indian group) 14

1.50
Ghuman et al 1995 (Indian group) 15 4.00
Jaiswal et al 1996 (Indian group) 16 1.78
Gosavi et al 1997 (Indian group) 17 15.90
Present study 2001 (Indian group) 1.50

The prevalence rate in the present study is close to studies done by Esteban et al, Choo et al, Irshad et al, Jaiswal et al and Narang et al.

Conclusions:

All transfusion centres screen the donors for HbsAg (HBV/Australia Antigen) and therefore the incidence of Post Transfusion Hepatitis (PTH) due to HBV has decreased remarkably. These days, more common cause of PTH is hepatitis C virus. Various studies have indicated different prevalence rates of HCV antibodies among healthy blood donors in USA, European countries and India. In the present study, we screened 21014 healthy blood donors and the prevalence rate of HCV antibodies was found to be 1.5%, which is comparable with other studies. This shows that HCV antibody screening should be carried out routinely in blood donors, which will assist blood transfusion services in improving blood product safety.

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