Download Frequency of Hepatitis B, C and Human Immunodeficiency Virus in

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 ofPathology and Department of Urzstroenterology & Hepatology, Shaikh Zayed Hospital.Lahore
SUMMARY
Objectives: To find o ut 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
H
epatitis 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
us ually 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
HBs Ag is quoted to be around I 0% in general
population while the prevalence of HCV in blood
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donors is 4.8%. Five to ten percent individuals
infected with HBV and app roximately 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.
Table I: Frequency of Hepatitis B in blood donors.
Sex
HBsAg +vc
HBsAg-vc
Male (n= l661 I)
Female (n= 1605)
Total (n= 1821 6)
543
69
612 (3.36%)
16068
1536
17604 (96.64%)
Table 2: Frequency of Hepatitis C in blood donors
Subject
Male (n= l661 l )
Female (n= 1605)
Total (n= l821 6)
SUBJECTS AND METHODS
In this study 18216 consecutive young
healthy volunta1y blood donors of either sex com ing
to Blood Bank of Shaikh Zayed Hospital, Lahore
were examined. The clinical details of these subjects
were recorded on a proforma. The blood samp les
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.
Anti-HCV +vc
Anti-HCV -ve
471
18
759 (4. 16%)
15870
1587
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
Anti-HIV -vc
0
0
0
166 1I
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.
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.
•
•
34
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 o r HIV pos itive
Frequency of Hepatitis B, C and Human Immunodeficiency Virus in Blood Donors
•
patients
Persons undergoing any surgical intervention
chronic hepatitis B with recombinant
interferon alpha therapy. J Coll Physician
Surg Pakistan 1997; 17: 145-47.
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.
9.
Mansoor SA, Mal ik IA, Tariq WZ, Butt SA,
Luqman M, Ahmad N. Hepatitis B related
liver disease
in Rawalpindi,
c hro nic
Islamabad area. J Col l Physician Surg
Pakistan 1997; 7: 43-47.
10.
Bhatti FA, Shaheen N, Tariq W, Amin M,
Saleem M. Epidemiology of hepatitis C virus
in blood donors of northern Pakistan. Pak
Armed Forces Med J 1996; 46: 91 -92.
11.
Chaudry N T, Khan SJ, Khan TA, Saeed M,
Iqba l J, Hayder Z, et al. Prevalence of
hepatitis B carrier and blood group frequency
in voluntary blood donors. J Ayub Med Coll
1996; 8: 29-32.
12.
Tanwani AK, Abbas KA. Comparative
evaluation of serodia and ELISA techniques
in the study of prevalence of HBsAg in
healthy blood donors at Is lamabad. J Col l
Phys Surg Pakistan 1996; 6: 187-88.
13.
Re hman N, Hashmi KZ. Hepatitis in
volunteer blood donors: a local experience.
Infectious Dis Pak 1996; 3: 24.
14.
Bukhari SM, Khatoon N, Iqbal A, Naeem S,
Shafqat S, Lone A, et al. Prevalence of
hepatitis B virus antigengenem ia in Mayo
Hospital, Lahore. Byomedica, 1999; 15: 8891.
I 5.
Hashmi ZY, C haudary A, Ahmed M, Ashraf
M. healthy voluntary blood donors; incidence
of a nti-HCV antibodies. Prof Med J 1999; 6:
551-55.
I 6.
Hashmi ZY, Chaudry A, Ahmed M, Ashraf
M. Hepatitis B antigengenem ia in healthy
blood donors at Faisalabad. Prof Med J 1999;
6: 547-50.
I 7.
Rehman K, Khan AA, Hayder S, Shehzad A,
Iqbal A, Khan R, et al. Prevalence of
seromarkers of HBV and HCV in health care
personnel and apparently healthy blood
donors. JPM 1996; 46: 152-54.
18.
Jadoon HA, Ahmed Z. Prevalence of antiHCV in blood donors of Hazara (NWFP).
PJMR 1999; 38: 7-9.
CONCLUSION
Awareness is necessary regarding safe blood
transfusion practice, and if data from all the blood
transfusion centers of o ur country is collected and
published, we can get representative prevalence
values of HBV, HCV and HIV in general population
of Pakistan.
REFERENCES
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World Health Report. 2001:
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B ukh J, Miller RH, Purcell RH. Genetic
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35
G. Sirhindi et al.
Zubair Ahmed,
Medical Officer
Pakistan Medical Research Council
Shaikh Zayed Hospital,
Lahore
The Authors:
Ghazanfar Ali Sirhindi ,
Demonstrator
Department of Pathology,
Shaikh Zayed Hospital,
Lahore
Maj. (R) Muhammad Shahid Naeem,
Shaikh Zayed Hospital,
Lahore
Anwaar A. Khan,
Professor
Department of Gastroenterology & Hepatology
Shaikh Zayed .Hospital,
Lahore
Waqar H. Shah,
Medical Officer
Department of Gastroenterology & Hepatology
Shaikh Zayed Hospital,
Lahore.
Saadia Shahzad Alam,
Assistant Professor
Department of Pharmacology
Shaikh Zayed Hospital,
Lahore
Akbar Hussain.
Shaikh Zayed Hospital,
Lahore
Muhammad Akram Ghori,
Shaikh Zayed Hospital,
Lahore
Razzaq Ahmed Chohan
Radioimmunoassay Lab.
Shaikh Zayed Hospital,
Lahore
Riaz-ur-Rehman,
Shaikh Zayed Hospital,
Lahore
Address for Correspondence:
Niaz Ahmed Soomro,
Shaikh Zayed Hospital,
Lahore
Ghazanfar Ali Sirhindi,
Demonstrator
Department of Pathol ogy,
Shaikh Zayed Hospital,
Lahore
36