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Introduction

Blood transfusion, an integral part of medicine and surgery, also carries the risk of transfusion-transmissible infections like hepatitis B, human immunodeficiency virus (HIV) 1 & 2, syphilis, malaria and infrequently toxoplasmosis, brucellosis & viral infections like cytomegalovirus (CMV), Epstein–Barr virus (EBV) and herpes [1] measuring their severity. World Health Organization (WHO) has recommended pre-transfusion blood test for HIV, hepatitis B (HBV), hepatitis C viruses (HCV), syphilis and malaria as mandatory [1]. All these diseases are capable of causing significant mortality, morbidity along with a financial burden for both the affected person and the country [2].

Every unit of blood transfusion there is a 1% chance of transfusion related complications including transfusion transmitted infections [1]. An increase in transfusion related infection has been reported in India [3]. India is already carrying a burden of 50 million of HBV carriers and 2027 million of HIV cases. Keeping in mind the grave consequences of these infections and to restrain the transmission to minimum, it is very important to remain vigilant about the possible spread of these diseases through blood transfusion [4].

In our study, we aimed to estimate the prevalence of HIV, HBV, HCV and syphilis among blood donors. Accurate estimates of risks of Transfusion transmitted infections (TTIs) are essential for monitoring safety of blood supply. Monitoring the incidence of TTIs in blood donors is important for estimating the risk of transfusion and optimizing donor recruitment strategies to minimize transmission. This knowledge might give us the idea of disease burden of the society and the basic epidemiology of these diseases in the community.

Materials and methods

A total number of 39780 samples of blood were collected from donors from January 2009 to December 2013 at KIMS Blood Bank, Secunderabad. Donors were selected by taking history, clinical examination and also following strict donor’s selection criteria to eliminate professional donors.

Samples were screened by Chemillumiences method (Architect Plus) for HIV-1 P24 antigen and anti-HIV 1 & 2 (4th generation ELISA), anti-HCV, HBsAg and anti-HBC. Samples reactive for anti-HBC was also tested for anti-HBs levels. Rapid Plasma Reagin (RPR) test kits (Carbogen Tulip) are used for screening syphilis and parabank kits for screening malaria parasite. All reactive samples were labeled as seropositive, disinfected and discarded.

Results

In the present study, out of total 39780 blood donors, 97.2% were males and 2.73% were females, which show predominance of males as compared to females [Table 1].

The prevalence of HBs Ag, anti-HCV, VDRL, and anti-HIV among voluntary blood donors in the study population were shown in [Figure 1]. The overall seroprevalence of HIV, HBV, HCV, syphilis were 0.26%, 1.28%, 0.515% and 0.037% respectively. The highest prevalence was observed for HBV followed by HCV, HIV and syphilis in decreasing order.

Table 1: Sex wise distribution of healthy donors.

Figure 1: Overall seropositivity and trends of HIV, HBV, HCV and syphilis.

Discussion

Blood and blood products are an integral and life saving procedures of modern medicine, but simultaneously it carries the risk of transmitting the life threatening transmissible infectious [2]. Screening of blood is now mandatory for many diseases and it is undertaken routinely in blood banks. Transmission of TTIs during the serologically window period still poses a threat to blood safety in environments where there is high rate of TTIs [4].

Our study seroprevalence of TTIs was as follows HIV 0.26%, HBV 1.28%, HCV 0.51% and syphilis 0.03%. No Blood donor test showed positivity for malaria parasite. The present study revealed overall prevalence of HIV seropositivity was 0.26%, which was similar to findings by Rajvir Singh et al. (0.25%) [2], Das BK et al. (0.32%) [5], Arora D et al. (0.3%) [6] and Patel SV et al. (0.30%) [7]. Variable results of 0.01% [8], 0.1% [9] and 0.64% [10] have also been reported in various other studies.

Present study revealed seroprevalence of HBV at 1.28% was lower than that reported by other studies by Arora D et al. (1.7%) [6], Sinha SK (2.27%) [10], Garg S (3.44%) [11], Nilima sawke (2.9%) [12], whereas few studies reported lower level of prevalence Arumugam et al. (0.74%) [8] and Luna Adhikari et al. (0.78%) [13].

HCV infection is an evolving public health problem globally. For hepatitis C, the estimated prevalence in this study was 0.51% familiar reported by Nilima Sawke et al. (0.57%) [12], yet another set of studies reported 1.0%, 0.23%, 0.35% by Aora D et al. [6], Pallavi et al. [14] and Das BK [5] respectively.

In this study, syphilis positivity was 0.03%, which are similar with the study done by S.T. Arumugam et al. [8] i.e. 0.03% whereas other studies reported 0.25%, 0.35%, 0.9%, 0.62% by Sangita Patel et al. [7], Das BK et al. [5], Arora D et al. [6] and Rajvir Singh et al. [3] respectively.

Conclusion

The time and cost involved in screening donated blood can be reduced by an effective donor education and selection criteria. Blood is still one of the leading risk factor of spread of the TTIs i.e. HIV, hepatitis B, hepatitis C viruses and syphilis.

Conflict of interest

The authors declare no conflict of interest.