Chauhan and Solanki: A study of transfusion transmissible infections in blood donors in blood bank of north Gujarat


Introduction

A transfusion of blood is a therapeutic process that delivers a good blood to the individual by an intravenous line (IV) that is obligatory for the survival of patients with blood loss. Blood, on the other side, is a perfect delivery medium for any contagious infection that can exist in the blood1. Blood transfusions if not monitored can lead to transmission of various infective agents which may endanger human life and also lead to morbidity and economic burden to the patients.1

A transfusion transmissible infection (TTI) is any infection that is transmissible from person to person through parenteral administration of blood or blood products for example hepatitis B (HBV), hepatitis C (HCV), Human Immunodeficiency Virus (HIV), syphilis, and less commonly to malaria, toxoplasmosis, brucellosis and other viral infections.2 Transfusion transmissible infectious diseases carry long term consequences for the recipients, families and the communities since the infected person represents a pool for the infection and can transmit the disease during its asymptomatic period.3, 4

In developing countries India, blood safety is a major issue due to the high prevalence of infectious agents among blood donors.5 The prevalence of human HIV in adults in India was recorded 0.2–0.3%.6 The prevalence of average hepatitis B surface antigen in India was 4.7% (range 1% to 3%).7 Overall, 0, 4-19.2% of blood donors had HCV infections.

While In India, HCV prevalence < 2% has been reported.8 Minimising the chances of transfusion transmitted infections (TTI) remains an important measure of blood transfusion safety. Due to availability of nucleic acid amplification technologies classic TTI like HIV, HBV and HCV are detected during window period of disease. Nowadays donor evaluation, highly sensitive laboratory screening tests and pathogen inactivation procedures are important measures to decrease the risk of TTI.9, 10

TTI are very common in all over India including Gujarat but studies on TTI in donors from north Gujarat areas are lacking. The present research is performed to establish the incidence and transfusion patterns transmitted infections in a tertiary care hospital of northern Gujarat.

Materials and Methods

The research was a sort of secondary analysis of the results. Blood donation data from January 2018 to February 2020 were taken in to analysis. The donor inclusion criteria were as follows: age 18 to 60, weight 45 kg, haemoglobin level at least 12 g percent, no history of hepatitis B and hepatitis C and sexually transmitted infections, no history of jaundice in the last 1 year. Both donors were questioned for high-risk actions for HIV, hepatitis B, and syphilis. All donors were categorised in to two groups; replacement donors and volunteer donors. Testing was carried out for donors from both the groups before blood transfusion. For HIV-1 & 2, HBsAg, and HCV, enzyme-linked immunosorbent assay or (ELISA) were carried out while Rapid Plasma regain test was carried out for screening of syphilis. HIV-1 and 2 were detected by any of these four kits: ENzaids, Pareekshak Erbaliza or Meriliza kits. HBV ad HCV testing were done by Erbalisa or merilisa kits. Syphilis screening was done by Reckon rapid test kits.

Data analysis

All data were entered and analysed through Epi info version 7. Categorical variables were expressed through numbers and percentages.

Results

In present study 4433 donors details were reviewed. Prevalence of Transfusion transmitted infection were described in Table 1. Overall prevalence of all TTIs was 2.12%. Percentages of HIV and HBsAg infection were 0.52% and 0.68% respectively in present study syphilis has prevalence of 0.81%. Highest prevalence of HIV and HBsAg were seen in 2018. HCV infection was seen only in 2019 which was 0.16%.

Age distribution of the study participants is shown in Table 2. Highest number of HIV, HBsAg and HCV positive donors were seen among 18 to 30 years of age while in case of syphilis, positive donors were belonged to 31- to 40 years of age group.

Table 3 describes distribution of TTIs among blood donors according to their type of donation. Replacement donor has significantly higher number of all TTIs (HIV, HCV, HBsAg and Syphilis) as compared to voluntary donors.

Table 1

Prevalence of TTIs among blood donors

TTIs

2018 (n=894)

2019 (n=3104)

2020 (Jan-feb) (n=435)

Total (n=4433)

HIV

07 (0.78%)

15 (0.48%)

01 (0.23%)

23 (0.52%)

HBsAg

13 (1.45%)

15 (0.48%)

02 (0.46%)

30 (0.68%)

HCV

00 (0.0%)

05 (0.16%)

00 (0.0%)

05 (0.11%)

VDRL

05 (0.56%)

26 (0.84%)

05 (1.5%)

36 (0.81%)

Total

25 (2.80%)

61 (1.97%)

08 (1.84%)

94 (2.12%)

Table 2

Age wise distribution of TTIs among blood donors (n=4433)

18-30

31-40

41-50

≥51

Total (n=4433)

HIV

13

06

04

00

23 (0.52%)

HbsAg

16

11

03

00

30 (0.68%)

HCV

03

01

00

01

05 (0.11%)

VDRL

11

16

07

02

36 (0.81%)

Total

43

34

14

03

94 (2.12%)

Table 3

Distribution of TTIs among blood donors according to their type of donation

TTIs

Replacement (n=587)

Voluntary (n=3846)

Total (n=4433)

P value

HIV

16 (2.72%)

07 (0.18%)

23 (0.52%)

<0.001

HBsAg

19 (3.24%)

11 (0.29%)

30 (0.68%)

<0.001

HCV

04 (0.68%)

01 (0.03%)

05 (0.11%)

<0.001

VDRL

28 (4.77%)

08 (0.21%)

36 (0.81%)

<0.001

Total

67 (11.41%)

27 (0.70%)

94 (2.12%)

<0.001

Discussion

Transfusion related infections ose more danger in the developing countries like India as compared to developed countries. Viral infections like HBV, HIV, and HCV are the main cause of morbidity and mortality in blood recipients. The overall prevalence of TTIs in our study was 2.12% which is almost similar as previous observations by Mandal R et al.11 (2,93%), Karmakar et al.12 (2.79%) and Koshy et al.13 In present study the HIV seroprevalence was 0.52%. In a study done by Suresh B et al.14 the seroprevalence of HIV amonst donor was 0.36% and Sindhu et al15 reported as low as 0.08%. In our study HIV prevalence amongst replacement donor was higher as 2.72% while in voluntary donor it was 0.52%. Sharma et al16 showed the prevalence of HIV 0.45% in replacement donors and 0.32% in voluntary donors while it was 0.44% and 0.15% in replacement and voluntary donor, respectively in Chandigarh.17 HIV transmission is possible during “window period” even if each unit is tested for HIV antibodies. This can be minimized by better selection of low-risk donors by stringent screening.

In our study, over all prevalence of HBV infection was 0.68%. Seroprevalence of HBV in the present study is in accordance with Gupta et al.18 who reported seropositivity of 0.66%. In our study, prevalence of HBV infection was 3.24% amongst replacement donor while in voluntary donor it was 0.29%. Kaur et al.17 reported 1.07% and 0.65% in replacement and voluntary donors; Pahuja et al19 reported much higher prevalence of 2.23%. Increasing trends of HBV infection was seen in replacement donors which may be due to fact that replacement donors conceal information about their health during donor selection to get the blood for their patient, thus compromising blood safety. In our study, over all prevalence of HCV infection was 0.11%. Same prevalence was reported in Gupta et al. from Punjab reported. In our study, prevalence of HCV infection was 0.68% amongst replacement donor while in voluntary donor it was 0.03%. Kaur et al.17 reported 0.5% and 0.3%, Sharma et al.16 reported 0.52% and 0.23% in replacement and voluntary donor, respectively. In our study, over all prevalence of syphilis infection was 0.81%. Studies done by Pallavi et al 1 and Arora et al20 reported prevalence of syphilis among blood donor was 0.23% and 0.9% respectively.

Conclusion

In the present research, the average prevalence of transfused infection among all donors was 2.12%. Blood donation is a Nobel job, and people must be inspired by it, but besides this, they must be trained and made cautious of the diseases transfused. Blood donors should screen themselves periodically for the various infections which may be present in the carrier stage. The pattern of transfusion transmissible infections may be different among the general population, but it can be used as monitoring tool.

Source of Funding

None.

Conflict of Interest

The authors declare that there is no conflict of interest.

References

1 

P Pallavi CK Ganesh K Jayashree GV Manjunath Seroprevalence and Trends in Transfusion Transmitted Infections Among Blood Donors in a University Hospital Blood Bank: A 5 Year StudyIndian J Hematol Blood Transfus2011271610.1007/s12288-010-0047-x

2 

SL Stramer FB Hollinger LM Katz S Kleinman PS Metzel KR Gregory Emerging infectious disease agents and their potential threat to transfusion safetyTransfus2009491S29S10.1111/j.1537-2995.2009.02279.x

3 

AD Kitchen JA Barbara Transfusiontransmitted Infections. Practical Transfusion MedicineSecond Edition200120836

4 

Z Ataro F Urgessa T Wasihun Prevalence and trends of major transfusion transmissible infections among blood donors in Dire Dawa blood bank, Eastern Ethiopia: Retrospective studyEthiop J Health Sci201828670110

5 

R Adhikary MV Bhavana The risk of transfusion transmissible infections. Where do we stand in 2018?Glob J Transfus Med2018328810.4103/gjtm.gjtm_33_18

6 

D Sachan J Varghese J Joseph V Srinivasan V Jayanthi M Rela HBsAg positive patient characteristics in hospital and blood donation campsISRN Hematol201310.1155/2013/675191

7 

S Narahari A Juwle S Basak D Saranath Prevalence and geographic distribution of Hepatitis C Virus genotypes in Indian patient cohortInfect Genet Evol200994643510.1016/j.meegid.2009.04.001

8 

RN Makroo RS Walia M Chowdhry A Bhatia V Hegde NL Rosamma Seroprevalence of anti-HCV antibodies among blood donors of north IndiaIndian J Med Res20131381125

9 

MP Busch EM Bloch S Kleinman Prevention of transfusion-transmitted infectionsBlood20191331718546410.1182/blood-2018-11-833996

10 

NK Naidu ZS Bharucha V Sonawane I Ahmed Nucleic acid testing: Is it the only answer for safe Blood in India?Asian J Transfus Sci2016107910.4103/0973-6247.175423

11 

R Mandal K Mondal Transfusion transmissible infections among blood donors from a sub-Himalayan rural tertiary care centre in Darjeeling, IndiaJ Tradit Complement Med20166224910.1016/j.jtcme.2015.02.003

12 

PR Karmakar P Shrivastava TG Ray Seroprevalence of transfusion transmissible infections among blood donors at the blood bank of a Medical College of KolkataIndian J Public Health2014586110.4103/0019-557x.128172

13 

JM Koshy A Manoharan M John R Kaur P Kaur Epidemiological profile of seropositive blood donors at a tertiary care hospital in North IndiaCHRISMED J Health Res2014129110.4103/2348-3334.134268

14 

KVS Babu B Suresh B Venkataramana PC Mouli Burden of transfusion transmissible viral infections among blood donors at a tertiary care referral teaching hospital in South IndiaJ Clin Sci Res201653160310.15380/2277-5706.jcsr.15.023

15 

M Sidhu U Kotwal R Kapoor T Raina Seroprevalence of human immunodeficiency virus, hepatitis B virus and hepatits C virus in blood donors of Jammu Province: A tertiary care centre experienceAsian J Transfus Sci20137216210.4103/0973-6247.115601

16 

RR Sharma R Cheema M Vajpayee U Rao S Kumar N Marwaha Prevalence of markers of transfusion transmissible diseases in voluntary and replacement blood donorsNatl Med J India2004171921

17 

G Kaur S Basu R Kaur P Kaur S Garg Patterns of infections among blood donors in a tertiary care centre: A retrospective studyNatl Med J India2010231479

18 

N Gupta V Kumar A Kaur Seroprevalence of HIV, HBV, HCV and syphilis in voluntary blood donorsIndian J Med Sci2004582557

19 

S Pahuja M Sharma B Baitha M Jain Prevalence and trends of markers of hepatitis C virus, hepatitis B virus and human immunodeficiency virus in Delhi blood donors: A hospital based studyJpn J Infect Dis20076038991

20 

D Arora B Arora A Khetarpal Seroprevalence of HIV, HBV, HCV and syphilis in blood donors in Southern HaryanaIndian J Pathol Microbiol201053230810.4103/0377-4929.64295



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