Asian Journal of Transfusion Science
Home About Journal Editorial Board Search Current Issue Ahead of print Back Issues Instructions Subscribe Login  Users: 486 Print this page  Email this page Small font sizeDefault font sizeIncrease font size 


 
ORIGINAL ARTICLE Table of Contents   
Year : 2010  |  Volume : 4  |  Issue : 2  |  Page : 91-93
Seroprevalence of HBV and HCV in blood donors: A study from regional blood transfusion services of Nepal


1 Department of Quality Assurance, Nepal Red Cross Society, Central Blood Transfusion Service, Kathmandu, Nepal
2 Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal

Click here for correspondence address and email

Date of Web Publication31-Jul-2010
 

   Abstract 

Background and Objective : Hepatitis B and hepatitis C are significant health problems that might involve the late sequel of liver cirrhosis and hepatocellular carcinoma. A high prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) in blood donors poses an increased risk of window period transmission through blood transfusion. The present study aimed to know the seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) among blood donors in regional blood transfusion services of Nepal. Materials and Methods: This was a retrospective study conducted among blood donors in Banke (5,211), Morang (5,351), and Kaski (5,995) blood transfusion services. Serum samples were tested for hepatitis B surface antigen (HBsAg) and anti-HCV antibodies using rapid enzyme immunoassays. The donors information was collected via the donor record register through their respective blood transfusion services. The software "Winpepi ver 3.8" was used for statistical analysis. Results: The seroprevalence rate of HBV was highest in the Banke (1.2%) followed by Biratnagar (0.87%) and Kaski (0.35%) (P < 0.0001). The seroprevalence of HCV was highest in the Morang (0.26%) followed by Kaski (0.16%) and Banke (0.11%) (P > 0.05). The seroprevalence of HBV was significantly higher than HCV in all three blood transfusion services. The burden of HBV as well as HCV seems to be higher in male donors (P > 0.05). Conclusion: The study revealed that the seroprevalence of HBV was alarmingly higher in two of the three blood transfusion services. Implementation of community-based preventive measures and improved strategies for safe blood supply might prove useful to decrease the seroprevalence.

Keywords: Blood donors, hepatitis B virus, hepatitis C virus, Nepal, seroprevalence

How to cite this article:
Tiwari B R, Ghimire P, Kandel S R, Rajkarnikar M. Seroprevalence of HBV and HCV in blood donors: A study from regional blood transfusion services of Nepal. Asian J Transfus Sci 2010;4:91-3

How to cite this URL:
Tiwari B R, Ghimire P, Kandel S R, Rajkarnikar M. Seroprevalence of HBV and HCV in blood donors: A study from regional blood transfusion services of Nepal. Asian J Transfus Sci [serial online] 2010 [cited 2021 Jul 31];4:91-3. Available from: https://www.ajts.org/text.asp?2010/4/2/91/67026



   Introduction Top


Hepatitis B virus (HBV) infection is one of the most common infectious diseases in the world with significant acute and chronic morbidity and thus has become a global public health problem. The presence of HBsAg in serum indicates active HBV infection, either acute or chronic. Usually, HBsAg is the first serologic marker in acute HBV infection and is detected 2-4 weeks before the alanine aminotransferase (ALT) level becomes abnormal and 3-5 weeks before symptoms or Jaundice. [1] World Health Organization (WHO) has estimated that more than 2 billion people in the world have been infected with HBV at some time in their lives and about 350 million people worldwide are HBV carriers with the majority in developing world mainly in Asia and Africa. [2] In Nepal, seroprevalence of HBsAg has been reported ranging from 0.3% to 4.0% in general population by various studies conducted from 1990 to 2003. [3],[4],[5],[6],[7],[8],[9] Among Nepalese blood donors, HBsAg seroprevalence has been reported ranging from 0.88% to 1.26%. [10],[11],[12]

Hepatitis C virus (HCV) continues to be a major disease burden in the world. In 1997, WHO estimated a worldwide prevalence of about 3% with the virus affecting 170 million people worldwide and 3 to 4 million new infections each year. [13] Among the viral hepatitis, HCV is dreadful in the aspect that its morbidity rate is high as it establishes a state of chronic infection in as many as 85% of acutely infected patients whereas about 15% of acutely infected patients spontaneously clear the infection. [14],[15] In Nepal, seroprevalence of anti-HCV antibodies among general population and blood donors has been reported ranging from 0.31.7%. [16],[17],[18],[19],[20]

Nepal is a country in South Asia, divided administratively into five development regions viz. Eastern, Central, Western, Mid Western, and Far Western development regions. The three regional blood transfusion services of Nepal viz. Morang, Banke, and Kaski, are situated in Eastern, Western, and Mid Western development regions, respectively. As Nepal is a country with considerable diversity of people in race, ethnic group, and in its socioeconomic condition, the status of hepatitis B and C might be different in different regions. A comparative study from three geographically and socioeconomically different regions would reveal important data that can be used to make plan and policy for assuring safe blood and would reveal the burden of disease in healthy looking general population in respective regions.


   Materials and Methods Top


This was a retrospective cross-sectional study conducted in three regional blood transfusion services of Nepal over a period of 1 year from July 2006 to June 2007. Blood donors were selected if they fulfilled all the criteria to be eligible for donation as described by the standard operating procedure of Nepal Red Cross Society, blood transfusion service. All blood donors donating blood in respective blood transfusion services or in mobile camps were included in the study. A total of 16,557 blood donors, namely 5,351 donors in Morang, 5,211 in Banke, 5,995 in Kaski, were subjected for routine mandatory screening for HBsAg and anti HCV antibodies by an enzyme immunoassay-based rapid tests according the standard protocol described by respective company (Hepacard, J. Mitra and Co., New Delhi, India and HCV TRI-DOT, J. Mitra and Co., New Delhi, India). Initially reactive sera were confirmed by repeat testing. Before drawing the blood each donor was requested to fill a blood donor's form. Blood samples were tested anonymously and confidentiality was maintained as per standard guidelines by Nepal Red Cross Society, blood transfusion service. The statistical analysis was done using the software "Winpepi ver 3.8" and the significance of difference in seroprevalence was tested by the Chi-square test.


   Results Top


In Morang (Biratnagar) Blood Transfusion Service, a total of 5,351 donors were screened in whom 84.8% (4,537/5,351) were males and 15.2% (814/5,351) were females. Among them 47 donors were found seropositive for HBV giving the seroprevalence of 0.87% (47/5,351, 95% CI= 0.6- 1.2%). The HBV seroprevalence in male donors was 0.96% (44/4,537) and in female donors was 0.36% (3/814) [Table 1]. The seroprevalence of HCV was found 0.26% all of whom were males (14/5,351, 95% CI= 0.1-0.4%). The difference in seroprevalence for HBV and HCV was statistically significant (P< 0.0001).

In Banke (Nepalgunj) Blood Transfusion Service, a total of 5,211 donors were screened in whom 91.5% (4,766/5,211) were males and 8.5% were females. Among them 63 were found to be seropositive for HBV giving the seroprevalence of 1.20% (63/5,211, 95% CI= 0.9-1.5%) of whom 62 were males and only 1 was female. The seroprevalence of HCV was 0.11% (6/5211, 95% CI= 0.0-0.3%), of whom all were males [Table 1]. The difference in seroprevalence for HBV and HCV was statistically significant (P< 0.0001)

In Kaski (Pokhara) Blood Transfusion Service, a total of 5,995 blood donors were screened in whom 87.5% (5,245/5,995) were males and 12.5% (750/5,995) were females. Among them 21 donors were found to be seropositive for HBV giving the seroprevalence of 0.35% (21/5,995, 95% CI= 0.2-0.5%) of whom 20 were males and only a single seropositive donor was female. The seroprevalence of HCV was 0.16% (10/5,995, 95% CI= 0.1-0.3%) of whom 8 were males and 2 were females [Table 1]. The difference in seroprevalence for HBV and HCV was statistically significant (P< 0.05).


   Discussion Top


The seroprevalence of HBV was highest in Banke followed by Biratnagar and then by Kaski (P < 0.0001). However, a study from central blood transfusion service, Kathmandu has shown a HBV seroprevalence of 0.53%. [21] The seroprevalence of HBV observed in Banke and Biratnagar was considerably higher than reported by a study from central blood transfusion service, Kathmandu; however, the seroprevalence observed in Pokhara was relatively lower. [21] The seroprevalence of HBV from Morang and Banke Blood Transfusion Services was similar to the seroprevalence reported by other studies conducted among blood donors in Nepal, but the seroprevalence from Kaski Blood Transfusion Service was relatively lower compared to these studies. [10],[11],[12]

The seroprevalence of HCV was highest in the Morang followed by Kanski and Banke (P > 0.05). However, a study by Karki et al., has reported that the nationwide prevalence of HCV at the same time period was 0.54% and in central blood transfusion service it was 0.7%. [22] Compared to the above report, the seroprevalence of HCV in all three regional blood transfusion services was considerably lower than the seroprevalence in Kathmandu valley. Similarly, the seroprevalence from all three blood transfusion service was lower than other studies regarding seroprevalence of HCV from blood donors and/or general population published from the Nepalese population. [16],[17],[18],[19] Similar to the present study, Shrestha et al., have reported a 0.35% seroprevalence of HCV among healthy adults with no significant difference in seroprevalence by geographic and development regions of Nepal. [20]

The study revealed that the problem of HBV as well as HCV was highest in Morang. The higher seroprevalence is the indicative of higher risk of transmission of blood borne infections due to serological window period. So, stringent donor selection criteria, effective donor education, community education and intervention to lower the prevalence in general population, blood donation by regular volunteer donors and donor notification, and counseling of seropositive donors might prove useful to lower the seroprevalence in blood donors. The present study showed that the seroprevalence of HBV was higher than HCV in all three blood transfusion service. So, special intervention programs should be planned to aware the general public about the highly infectious nature of HBV and its mode of transmission. Hepatitis B is vaccine preventable, so the need, suitability, and feasibility of mass vaccination programs in populations showing such higher prevalence should be studied.


   Acknowledgement Top


The authors would like to thank Nepal Red Cross Society, central blood transfusion service, and regional blood transfusion services for their support during this study.

 
   References Top

1.Horvat RT, Tegtmeier GE. Hepatitis B and D Viruses. In: Murray PR, Baron EJ, Jorgensen JH, Pfaller M, Yolken RH, editors. Manual of Clinical Microbiology, 8th ed, Vol 2. Washington DC, ASM Press; 2003.  Back to cited text no. 1      
2.World Health Organization. Available from: http://www.who.int/gpv-surv/graphics/htmls/hepbprev.htm [last accessed on 2009 Nov 16].  Back to cited text no. 2      
3.Nakashima K, Kashiwaqi S, Noquchi A, Hirata M, Hayashi J, Kawasaki T, et al. Human T-lymphotropic virus type-I, and hepatitis A, B and C viruses in Nepal: A serological survey. J Trop Med Hyg 1995;98:347-50.  Back to cited text no. 3      
4.Shrestha SM. Seroepidemiology of Hepatitis B in Nepal. J Commun Dis 1990;22:27-32.  Back to cited text no. 4  [PUBMED]    
5.Manandhar K, Shrestha B. Prevalence of HBV infection among the healthy Nepalese males: A serological survey. J Epidemiol 2000;10:410-3.  Back to cited text no. 5  [PUBMED]    
6.Sawayama Y, Hayashi J, Ariama I, Furusyo N, Kawasaki T, Kawasaki M, et al. A ten years serological survey of hepatitis A, B and C viruses infections in Nepal. J Epidemiol 1999;9:3504.  Back to cited text no. 6      
7.Joshi SK, Ghimire GR. Serological prevalence of antibodies to human immunodeficiency virus (HIV) and hepatitis B virus (HBV) among healthy Nepalese males--a retrospective study. Kathmandu Univ Med J (KUMJ) 2003;1:251-5.  Back to cited text no. 7  [PUBMED]    
8.Rai SK, Shibata H, Satoh M, Murakoso K, Sumi K, Kubo T, et al. Seroprevalence of hepatitis B and C viruses in eastern Nepal. Kamsenshogaku Zasshi 1994;68:1492-7.  Back to cited text no. 8      
9.Bhatta CP, Thapa B, Rana BB. Seroprevalence of hepatitis "B" in Kathmandu Medical College Teaching Hospital (KMCTH). Kathmandu Univ Med J (KUMJ) 2003;1:113-6.  Back to cited text no. 9  [PUBMED]    
10.Joshi M, Manandhar SP, Ghimire P. Seroprevalence of hepatitis B and Hepatitis C infection among blood donors of Kathmandu Valley. J Institute of Science Tech 2002;12:43-50.  Back to cited text no. 10      
11.Ghimire P, Thapa D, Rajkarnikar M, Tiwari BR. HBsAg Seroprevalence in Blood donors of Kathmandu, Nepal. Stupa Jour of Health Sci 2006; 2;24-6.   Back to cited text no. 11      
12.Ghimire P, Dhungyel BB, Tiwari BR. Hepatitis B and malaria among Nepalese blood donors. Jour Scientific World 2007;5:81-4.  Back to cited text no. 12      
13.Hepatitis C: Global prevalence. Wkly Epidemiol Rec 1997;72:341-8.  Back to cited text no. 13      
14.Alter MJ, Margolis HS, Krawczynski K, Judson FN, Mares A, Alexander WJ, et al. The natural history of community acquired hepatitis C in the United States. N Engl J Med 1992;327:1899-905.  Back to cited text no. 14  [PUBMED]  [FULLTEXT]  
15.Villano SA, Vlahov D, Nelson KE, Cohn S, Thomas DL. Persistence of viremia and the importance of long term follow up after acute hepatitis C infection. Hepatology 1999;29:908-14.  Back to cited text no. 15  [PUBMED]  [FULLTEXT]  
16.Singh R. Prevalence of hepatitis C in blood donors--A pilot study. JNMA J Nepal Med Assoc 1998;30: 1--6.  Back to cited text no. 16      
17.Shrestha SM, Shrestha S, Tsuda F, Sawada N, Tanaka T, Okamoto H, et al. Epidemiology of hepatitis C virus infection in Nepal. Trop Gastroenterol 1998;19:102-4.  Back to cited text no. 17      
18.Joshi M, Manandhar SP, Ghimire P. Seroprevalence of Hepatitis B and Hepatitis C Infection among Blood Donors of kathmandu Valley. J Institute Science Tech 1999;12:43-50.  Back to cited text no. 18      
19.Shrestha IL. Seroprevalence of antibodies to hepatitis C virus among injecting drug users from Kathmandu. Kathmandu Univ Med J 2003;1:101-3.  Back to cited text no. 19      
20.Shrestha B. Serological surveillance of Anti HCV antibody among Nepalese males. JNHRC 2006;4:7-11.  Back to cited text no. 20      
21.Karki S, Ghimire P, Tiwari BR, Rajkarnikar M. HBsAg Serosurveillance among Nepalese Blood Donors. Ann Trop Med Public Health, 2008; 11: 15-18.  Back to cited text no. 21      
22.Karki S, Ghimire P, Tiwari BR, Maharjan A, Rajkarnikar M. Trends in Hepatitis B and Hepatitis C Seroprevalence among Nepalese blood donors. Jpn J Infect Dis 2008;61:324-6.  Back to cited text no. 22  [PUBMED]  [FULLTEXT]  

Top
Correspondence Address:
B R Tiwari
Nepal Red Cross Society, Central Blood Transfusion Service, Kathmandu
Nepal
Login to access the Email id

Source of Support: Nepal Red Cross Society, central blood transfusion service, and regional blood transfusion services,, Conflict of Interest: None


DOI: 10.4103/0973-6247.67026

Rights and Permissions



 
 
    Tables

  [Table 1]

This article has been cited by
1 Prevalence of chronic hepatitis B virus infection before and after implementation of a hepatitis B vaccination program among children in Nepal
Shyam Raj Upreti,Santosh Gurung,Minal Patel,Sameer M. Dixit,L. Kendall Krause,Geeta Shakya,Kathleen Wannemuehler,Rajesh Rajbhandari,Rajendra Bohara,W. William Schluter
Vaccine. 2014;
[Pubmed] | [DOI]



 

Top
 
  Search

  
  
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Email Alert *
    Add to My List *
* Registration required (free)  


    Abstract
    Introduction
    Materials and Me...
    Results
    Discussion
    Acknowledgement
    References
    Article Tables

 Article Access Statistics
    Viewed4418    
    Printed240    
    Emailed2    
    PDF Downloaded123    
    Comments [Add]    
    Cited by others 1    

Recommend this journal

Association Contact us | Sitemap | Advertise | What's New | Feedback | Copyright and Disclaimer

2006 - Asian Journal of Transfusion Science | Published by Wolters Kluwer - Medknow
Online since 10th November, 2006