SCREENING OF PROSPECTIVE BLOOD DONORS FOR TRANSFUSION TRANSMISSIBLE VIRUSES USING SINGLE AND MULTIPANEL MARKERS IN EKITI STATE, NIGERIA

SOURCE:

Faculty: Health Sciences And Technology
Department: Medical Laboratory Science

CONTRIBUTORS:

Fasakin, K.O;
Amilo, G.I;

ABSTRACT:

Blood transfusion comes with its various risks especially as it concerns transmission of blood-borne infections. Hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) screening are mandatory for certifying blood donors fit for donation. This study seeks to advance serologic screening of transfusion transmissible viruses (HBV, HCV and HIV) in prospective blood donors (PBD) to include the use of multipanel markers based procedures and compare them with the real-time polymerase chain reaction (RT-PCR) as the gold standard. Four hundred and seventy (470) PBD were screened for HBsAg and HBV markers while 300 and 140 PBD were screened for anti-HCV and HIV-1/2 respectively between August, 2014 and November, 2015 based on differences in prevalence of viral agents. Serologic screening for the viruses; estimation of alanine aminotransferase (ALT) level as well as confirmatory and viral load assays were performed on plasma samples separated from blood donors. First-line serologic assays were performed by rapid enzyme immunoassay techniques and subsequent HBsAg, HCV Ag-Ab and HIV Ag-Ab detection by ELISA technique. Confirmatory and quantification assays were performed with RT-PCR. ALT level was estimated spectrophotometrically. Descriptive statistics, student t-test and Chi square analytical tools of the Statistical Package for Social Sciences version 21 software were used to analyse data. P ≤ 0.05 was statistically significant. The results showed that the overall mean age and gender ratio of PBD were 26.87 ± 7.51years and 1.5:1 respectively. Prospective blood donors had statistically significant knowledge of hepatitis B and C viral transmission routes (χ2 range = 11.6 - 102.3) as well as HIV transmission routes (χ2 range = 63.3 - 212.7).Hepatitis B surface antigenaemia in voluntary blood donors and paid blood donors were 6.1% and 14.3%respectively based on Diaspot and HBsAg strip of multipanel5-in-1 rapid enzyme immunoassay (MP-EIA). Genscreen Monolisa assay gave 6.6% and 17.1% respectively. Cummulative HBV markers seroprevalence based on different HBV markers seropositivity patterns was 19.36% and the impact of age groups of PBD on it was statistically significant (p = 0.002). Anti-HCV seroprevalence was 0.33% by ELISA technique compared to 1.67% by Diaspot rapid EIA. Overall HIV seroprevalence was 2.9% irrespective of methods used. Comparison of serologic techniques using real-time PCR as the gold standard, and diagnostic odds ratio (DOR) showed that 5-in-1 HBV rapid EIA was nearly 7-fold better than ELISA technique (adjusted DOR: 53,740 compared to 7,625) for HBsAg detection; ELISA technique for HCV Ag-Ab detection was 9-fold better as a screening tool than Diaspot rapid EIA (adjusted DOR: 1,764.7 compared to 196.1). The mean HBV-DNA viral load and ALT of chronic inactive carriers of HBV were 1311.0 ± 1165.5 IU/mL and 15.5 ± 1.5 IU/L while those of chronic immune tolerant hepatitis B infected blood donors were 31313849.7 ± 5726513.5 IU/mL and 17.7 ± 1.2 respectively. HIV-1/2 antibody rapid technique based on serial algorithm showed similar results with ELISA and RT-PCR. In conclusion, multi-panel markers serologic techniques rather than the single-marker based techniques enhanced optimal blood safety practices and post-test counselling of blood donors.

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