Proceeding S.Z.P.G.M.I. vol: 19(1): pp. 33-36, 2005.

Frequency of Hepatitis B, C and Human Immunodeficiency Virus in Blood Donors at

Shaikh Zayed Hospital, Lahore Ghazanfar Ali Sirhindi, Anwaar A. Khan, Saadia Shahzad Alam, Muhammad Akram Ghori, Riaz-ur­Rehman, Niaz Ahmed Soomro, Zubair Ahn1ed, Maj. (R) Muhammad Shahid Naeem, Waqar H. Shah,

Akbar Hussain. Razzaq Ahmed Chohan Department of Pathology and Department of Urzstroenterology & Hepatology, Shaikh Zayed Hospital.Lahore

SUMMARY

Objectives: To find out the frequency of hepatitis B, C and human immunodefic iency vi rus (HIV) in blood donors at Shaikh Zayed Hospital, Lahore. Design: This is a non-interventional study. Study Period: Period of this study is from 1-1-2005 to 30-6-2005. Setting: Study was conducted at the Blood Bank of Shaikh Zayed Hospital, Lahore. Subjects and Methods: In this study 18216 young healthy voluntary blood donors (age 16-50 years) comprising of 16611 males and 1605 females were included and tested for HBsAg, Anti-HCV and HIV by Accu check one step test (chromatographic immunoassay) in serum. Results: Frequency of hepatitis B, C and HIV infection was 3.36%, 4. l 6% and 0% respectively. Conclusion: We can get representative prevalence values of HBV, HCV and HIV infection in general population by collecting data from all blood transfusion centers of Pakistan. This is also helpful to create public awareness regarding hepatiti s and HIV transmission through blood transfusion.

Key Words: Hepatitis B virus, Hepatitis C virus, Human immunodeficiency virus, Blood donors.

INTRODUCTION

Hepatitis B is a major health problem worldwide. Approximately two billion people

in the world have been infected by hepatiti ,; B virus. 1 Hepatitis C virus poses a more difficult health problem than hepatitis B virus. 85% of people with HBV infection resolve their infection and only 15% become chronically infected. This is just the opposite in case of HCV infection due to many HCV genotype variants.2 Unfortunately, there has been marked under-reporting of the HIV infection and the report issued by the National AIDS Control Programme of Pakistan has shown a total of 1262 cases of HIV infection with 142 cases of AIDS by October I 997. There is an urgent need for screening of HIV cases for effective control of the disease.3

Viral hepatitis is a common public health problem in Pakistan.4 Approximately I 0 million

people are infected with HCV in Pakistan. Regarding hepatitis C in childhood, infection is usually a very benign illness, but chronic infection often leads to cirrhosis and hepatocellular cancer after many years.5 One hundred and seventy million people are infected with hepatitis C out of which 70% have chronic hepatitis and 15 to 20% will develop cirrhosis and its consequences.6 In Pakistan, hepatitis B virus and hepatitis C virus infections are due to unsatisfactory hygiene, poor socioeconomic condition and low literacy rate. The carrier rate of HBsAg is quoted to be around I 0% in general population while the prevalence of HCV in blood donors is 4.8%.

7 Five to ten percent individuals

infected with HBV and approximately half of patients infected with HCV progress to chronic stage.8 Cirrhosis is the most common cause of hepatitis B related chronic liver diseases in Pakistan accounting for 58% cases followed by hepatocell ular carcmoma (22%) and chronic

G. Sirhindi et al.

hepatitis (20%).9

Data regarding the prevalence of hepatitis B and C virus infections among healthy blood donors is well established in big cities of Pakistan, but similar data regarding the epidemiology of HIV infection among blood donors is not available at most of the blood transfusion centers. The purpose of this study is to determine the prevalence of hepatitis B, hepatitis C and HIV infections in the blood donors and to create public awareness regarding hepatitis and HIV.

SUBJECTS AND METHODS

In this study 18216 consecutive young healthy volunta1y blood donors of either sex coming to Blood Bank of Shaikh Zayed Hospital, Lahore were examined. The clinical details of these subjects were recorded on a proforma. The blood samples were collected by venepuncture using sterile disposable syringes. Fresh serum samples were tested for the presence of hepatiti s B surface antigen. Anti-HCV antibodies and anti-HIV antibodies by commercially available kits with Accu one step test (a rapid chromatographic immuno­assay). Procedure was strictly followed as given in the manual of kit. Negative and positive controls were run with each batch of samples.

RESULTS

A group of 18216 young healthy vo luntary blood donors (age 16-50 years) comprising of 16611 males and 1605 females were tested for hepatitis B, C and HIV infections. Frequency of hepatitis B, C and HIV infection were 3 .36%, 4.16% and 0% respectively (Tables 1-3).

_ .. DISCUSSION

It is important to assess the problem in the community and to understand the methods to control its transmission. Hepatitis B, C and HIV infection have been the cause of s ignificant morbidity and mortality worldwide, but more in the developing countries like Pakistan. Studies to determine the prevalence of HBV, HCV and HIV infection have been done on healthy blood donors.

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Table I: Frequency of Hepatitis B in blood donors.

Sex HBsAg +vc HBsAg-vc

Male (n= l661 I) 543 16068 Female (n= 1605) 69 1536 Total (n=1821 6) 612 (3.36%) 17604 (96.64%)

Table 2: Frequency of Hepatitis C in blood donors

Subject Anti-HCV +vc Anti-HCV -ve

Male (n= l661 l ) 471 15870 Female (n= 1605) 18 1587 Total (n= l821 6) 759 (4.16%) 17457 (95.84%)

Table 3: Frequency of HIV in blood donors

Subject

Male (n= 166 11 ) Female (n= 1605) Total (n= l 8216)

Anti-HIV +ve

0 0 0

Anti-HIV -vc

166 1 I 1605

18216 ( 100%)

In this study, 18216 voluntary blood donors were included. Frequency of hepatitis B, C and HIV infection were 3 .3 6%, 4.16% and 0% respectively . In nine studies'°-18 on the prevalence of HBV and HCV in healthy b lood donors, 3 addressed HBV on ly, 3 focused on HCV while 3 highlighted both B and C prevalence. Fortunately all the 18216 subjects were HIV negative. The exact prevalence of HIV in the general population of Pakistan is not known. As HIV test is being routinely done at the blood transfusion centers, it is recommended that data from all the centers should be collected and published and we recommend the pol icy of routine screening in the following c ircumstances.

• Persons on hemodialysis • Those who inject illegal drugs • Persons receiving clotting factors • Unexplained skin infections • Persons with organ transplants • Children of HCV, HBV or HIV positive

mothers • Health care workers, medical and public

safety staff after needle injury • Close contacts of HCV, HBV or HIV pos itive

Frequency of Hepatitis B, C and Human Immunodeficiency Virus in Blood Donors

patients

• Persons undergoing any surgical intervention

However, prevalence studies of healthy blood donors for HBV, HCV and HIV may be regarded as near estimates of the prevalence in the general population. As mandatory testing for HBsAg, anti­HCV and HIV along with blood grouping is being done in the blood transfusion centers, this facility should be utilized for prevalence studies.

CONCLUSION

Awareness is necessary regarding safe blood transfusion practice, and if data from all the blood transfusion centers of our country is collected and published, we can get representative prevalence values of HBV, HCV and HIV in general population of Pakistan.

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chronic hepatitis B with recombinant interferon alpha therapy. J Coll Physician Surg Pakistan 1997; 17: 145-47.

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The Authors:

Ghazanfar Ali Sirhindi , Demonstrator Department of Pathology, Shaikh Zayed Hospital, Lahore

Anwaar A. Khan, Professor Department of Gastroenterology & Hepatology Shaikh Zayed .Hospital, Lahore

Saadia Shahzad Alam, Assistant Professor Department of Pharmacology Shaikh Zayed Hospital, Lahore

Muhammad Akram Ghori, Shaikh Zayed Hospital, Lahore

Riaz-ur-Rehman, Shaikh Zayed Hospital, Lahore

Niaz Ahmed Soomro, Shaikh Zayed Hospital, Lahore

G. Sirhindi et al.

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Zubair Ahmed, Medical Officer Pakistan Medical Research Council Shaikh Zayed Hospital, Lahore

Maj. (R) Muhammad Shahid Naeem, Shaikh Zayed Hospital, Lahore

Waqar H. Shah, Medical Officer Department of Gastroenterology & Hepatology Shaikh Zayed Hospital, Lahore.

Akbar Hussain. Shaikh Zayed Hospital, Lahore

Razzaq Ahmed Chohan Radioimmunoassay Lab. Shaikh Zayed Hospital, Lahore

Address for Correspondence:

Ghazanfar Ali Sirhindi, Demonstrator Department of Pathology, Shaikh Zayed Hospital, Lahore