Prevalence and Characterization of Hepatitis B and Hepatitis C Infection among Blood Donors in Erbil
Blood transmitting infectious disease still remains a considerable global health problem. Hepatitis B virus (HBV) and hepatitis C virus (HCV) are two of the most commonly transmitted infectious agents. This prospective cross-sectional study was conducted between December, 2017, and February, 2018, at the Directorate of Blood Bank in Erbil Province, Northern Iraq. During that period, a total of 6173 blood donors donated blood; all blood donors were asked a series of questions through a structured questionnaire designed for such purpose. These patients were serologically examined for HBV and HCV. Positive blood samples were further analyzed serologically and confirmed by real-time polymerase chain reaction (RT-PCR). Among 6173 blood donors who were investigated for HBV, 7 (0.11%) and 98 (1.6%) were positive for hepatitis B urface antigen (HBs-Ag) and hepatitis B core Antibody (HBc-Ab), respectively, whereas during screening for HCV, 4 (0.06%) were positive for HCV-Ab. Coinfection (dual infection (HBV and HCV) was positive in 1 patient (0.01%). Among 98 reactive samples, 75.5% were positive for HBs antibody (HBs-Ab), the remaining 24 samples (24.5%) were regarded as occult hepatitis B infection (OBI), since they were positive for HBc-Ab, whereas negative both for HBs-Ag and HBs-Ab. The diagnosis of OBI could be confirmed by RT-PCR in 8 samples, 33% of samples. The overall incidence of HBV and HCV among examined blood donors was 0.5 %, and 0.06%, respectively. Amidst that incidence, 0.39 % were diagnosed as OBI. To prevent viral transmission through blood transfusion is needed to combine a different and sensitive method for HBV detection as well as volve tests that have high sensitivity and specificity for serological markers. Moreover, a molecular tool that is sensitive enough to detect very low copies of viral DNA must also be developed.
B. Liu, J. Li, Y. Han, Y. Liu, L. Kong, Y. Cao and Z. J. H. Huang. “Dynamic analysis of lymphocyte subsets of eripheral blood in patients with acute self-limited hepatitis B”. Health, vol. 2, pp. 736-741, 2010.
J. A. Hobden and K. C. Carroll. “Jawetz, Melnick and Adelberg’s Medical Microbiology”. New York: McGraw-Hill, 2016.
S. Amini Kafi-abad, H. Rezvan, H. Abolghasemi and A. Talebian. “Prevalence and trends of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus among blood donors in Iran, 2004 through 2007”. Transfusion, vol. 49, pp. 2214-2220, 2009.
Y. Song, Y. Bian, M. Petzold and C.O. Ung. “Prevalence and trend of major transfusion-transmissible infections among blood donors in Western China, 2005 through 2010”. PLoS One, vol. 9, p. e94528, 2014.
D. Candotti and J. P. Allain. “Transfusion-transmitted hepatitis B virus infection”. Journal of Hepatology, vol. 51, pp. 798-809, 2009.
C. Velati, L. Fomiatti, L. Baruffi, V. Piccinini, D. Prati, A. Reina, A. Lobbiani, A. Zanetti and L. Romanò. “Criteria for hepatitis B virus screening and validation of blood components in Italy: The position of the SIMTI HBV working group”. Blood Transfusion, vol. 9, pp. 455-461, 2011.
M. K. Hourfar, L. A. Walch, G. Geusendam, T. Dengler, K. Janetzko, K. Gubbe, K. Frank, A. Karl, M. Löhr, W. Sireis, E. Seifried and M. Schmidt. “Sensitivity and specificity of anti-HBc screening assays which assay is best for blood donor screening”? International Journal of Laboratory Hematology, vol. 31, pp. 649-656, 2009.
Y. H. Majeed. “Hepatitis B surface antigen prevalence among screened populations and certain risk groups in AL-Anbar governorate, West of Iraq”. Al-Anbar Medical Journal, vol. 13, pp. 14-19, 2016.
N. G. Sawke and G. Sawke. “Preventing post-transfusion hepatitis by screening blood donors for IgM Antibody to hepatitis B core antigen”. Journal of Global Infectious Diseases, vol. 2, pp. 246-247, 2010.
G. Raimondo, T. Pollicino, I. Cacciola and G. Squadrito. “Occult hepatitis B virus infection”. Journal of Hepatology, vol. 46, pp. 160-170, 2007.
J. H. MacLachlan and B. C. Cowie. “Hepatitis B virus epidemiology”. Cold Spring Harbor Perspectives in Medicine,
vol. 5, p. a021410, 2015.
D. N. Noah, F. A. Andoulo, B. V. M. Essoh, G. N. Ayissi, S. A. F. Bagnaka and M. B. Sida. “Prevalence of HBs antigen, and HCV and HIV antibodies in a young male population in Cameroon”. Open Journal of Gastroenterology, vol. 5, pp. 185-190, 2015.
J. Lara, F. X. López-Labrador, F. González-Candelas, M. Berenguer and Y. E. Khudyakov. “Computational models of liver fibrosis progression for hepatitis C virus chronic infection”. BMC Bioinformatics, vol. 15, p. S5, 2014.
F. Sorvillo, G. Mazziotti, A. Carbone, F. Morisco, M. Cioffi, M. Rotondi, G. Stornaiuolo, G. Amato and G. B. Gaeta.
“Increased serum reverse triiodothyronine levels at diagnosis of hepatocellular carcinoma in patients with compensated HCVrelated liver cirrhosis”. Clinical Endocrinology, vol. 58, pp. 207-212, 2003.
N. R. Hussein, S. M. Haj, L. A. Almizori and A. A. Taha. “The prevalence of hepatitis B and C viruses among blood donors attending blood bank in Duhok, Kurdistan region, Iraq”. International Journal of Infection, vol. 4, p. 39008, 2017.
A. M. Tarky, W. Akram, A. S. Al-Naaimi and A. Omer. “Epidemiology of viral hepatitis B and C in Iraq: A national survey 2005-2006”. Zanco Journal of Medical Sciences, vol. 17, pp. 370-380, 2013.
A. Al-Rubaye, Z. Tariq and L. Alrubaiy. “Prevalence of hepatitis B seromarkers and hepatitis C antibodies in blood donors in Basra, Iraq”. BMJ Open Gastroenterology, vol. 3, p. e000067, 2016.
I. H. Saadoon. “Seroprevalence of HGV among blood donors with HCV and/or HBV in Tikrit city”. Tikrit Journal of Pharmaceutical Sciences, vol. 11, pp. 15-20, 2016.
H. B. El-Serag. “Epidemiology of viral hepatitis and hepatocellular carcinoma”. Gastroenterology, vol. 142, pp. 1264-1273, 2012.
A. M. Alsamarai, G. Abdulrazaq, A. Fatah and A. Alobaidi. “Seroprevalence of hepatitis B virus in Iraqi population”.
Journal of Vaccines, Immunology and Immunopathology, vol. 2016, p. J102, 2016.
T. D. Ly, A. Servant-Delmas, S. Bagot, S. Gonzalo, M. P. Ferey, A. Ebel, E. Dussaix, S. Laperche and A. M. Roque-Afonso. “Sensitivities of four new commercial hepatitis B virus surface antigen (HBsAg) assays in detection of HBsAg mutant forms”.Journal of Clinical Microbiology, vol. 44, pp. 2321-2326, 2006.
A. A. Olotu, A. O. Oyelese, L. Salawu, R. A. Audu, A. P. Okwuraiwe and A. O. Aboderin. “Occult hepatitis B virus infection in previously screened, blood donors in Ile-Ife, Nigeria: Implications for blood transfusion and stem cell transplantation”. Virology Journal, vol. 13, 76, 2016.
S. Kinn, S. Akhavan, H. Agut and V. Thibault. “Performance of the DiaSorin LIAISON® anti-HBs II for the detection of hepatitis B surface antibodies: Comparison with the Abbott Architect anti-HBs assay”. Journal of Clinical Virology, vol. 50, pp. 297-302, 2011.
H. A. Croom, K. M. Richards, S. J. Best, B. H. Francis, E. I. M. Johnson, E. M. Dax and K. M. Wilson. “Commercial enzyme immunoassay adapted for the detection of antibodies to hepatitis C virus in dried blood spots”. Journal of Clinical Virology, vol. 36, pp. 68-71, 2006.
H. Frickmann, R. Hinz and R. Hagen. “Comparison of an automated nucleic acid extraction system with the column-based procedure”. European Journal of Microbiology and Immunology, vol. 5, 94-102, 2015.
M. S. Han, Y. Park, H. Nah and H. S. Kim. “Comparison of the QIAGEN artus HBV QS-RGQ assay with the roche COBAS AmpliPrep/COBAS TaqMan HBV assay for quantifying viral DNA in sera of chronic hepatitis B patients”. Annals of Laboratory Medicine, vol. 37, p. 248, 2017.
World Health Organization. “Global Health Sector Strategy on Viral Hepatitis, 2016-2021”. Geneva: World Health Organization, 2016.
E. Franco, B. Bagnato, M. G. Marino, C. Meleleo, L. Serino and L. Zaratti. “Hepatitis B: Epidemiology and prevention in developing countries”. World Journal of Hepatology, vol. 4, p. 74, 2012.
J. J. Ott, G. A. Stevens, J. Groeger and S. Wiersma. “Global epidemiology of hepatitis B virus infection: new estimates of age-specific HBsAg seroprevalence and endemicity”. Vaccine, vol. 30, pp. 2212-2219, 2012.
K. M. Hanafiah, J. Groeger, A. D. Flaxman and S. T. Wiersma. “Global epidemiology of hepatitis C virus infection: New estimates of age-specific antibody to HCV seroprevalence”. Hepatology, vol. 57, pp. 1333-1342, 2013.
H. S. Q. Alhilfi, R. A. H. Alhashimi and R. K. A. Alsaad. “Seroprevalence of hepatitis B and hepatitis C virus among blood donors in missan governorate-Iraq”. International Journal of Innovation and Applied Studies, vol. 11, pp. 816-820, 2015.
H. Boustani, E. Anvari, S. SaiadiSartang, M. Omidi, E. Rostami and Z. Mohamadi. “Prevalence of HIV, hepatitis B and C infections among volunteer blood donors at the blood transfusion center of Ilam city, Iran”. Journal of Basic Research in Medical Sciences, vol. 4, pp. 4-8, 2017.
S. M. Sajjadi, A. A. Pourfathollah, S. Mohammadi, B. Nouri, R. Hassanzadeh and F. Rad. “The prevalence and trends of hepatitis B, hepatitis C, and HIV among voluntary blood donors in kohgiluyeh and boyer-ahmad transfusion center, Southwestern Iran”. Iranian Journal of Public Health, vol. 47, pp. 944-951, 2018.
S. P. S Gulia. “Seroprevalence of hepatitis B virus infection among blood donors in local population”. The Internet Journal of Pathology, vol. 10, pp.29-33, 2010.
S. R. Qowaider, M. S. Ali, S. A. Moftah and F. A. Khaled. “Prevalence of HBV and HCV infections among blood donors in Northeast Libya”. International Blood Research and Reviews, vol. 7, pp. 1-5, 2017.
V. D. Hope, I. Eramova, D. Capurro and M. Donoghoe. “Prevalence and estimation of hepatitis B and C infections in the WHO European region: A review of data focusing on the countries outside the European Union and the European free trade association”. Epidemiology and Infection, vol. 142, pp. 270-286, 2014.
M. S. Kwak and Y. J. Kim. “Occult hepatitis B virus infection”. World Journal of Hepatology, vol. 6, pp. 860-869, 2014.
H. Hennig, I. Puchta, J. Luhm, P. Schlenke, S. Goerg and H. Kirchner. “Frequency and load of hepatitis B virus DNA in firsttime blood donors with antibodies to hepatitis B core antigen”. Blood, vol. 100, pp. 2637, 2002.
S. H. Kleinman, M. C. Kuhns, D. S. Todd, S. A. Glynn, A. McNamara, A. DiMarco, M. P. Busch and For The Retrovirus
Epidemiology Donor Study. “Frequency of HBV DNA detection in US blood donors testing positive for the presence of anti-HBc: Implications for transfusion transmission and donor screening”. Transfusion, vol. 43, pp. 696-704, 2003.
M. Sofian, A. Aghakhani, N. Izadi, M. Banifazl, E. Kalantar, A. Eslamifar and A. Ramezani. “Lack of occult hepatitis B virus infection among blood donors with isolated hepatitis B core antibody living in an HBV low prevalence region of Iran”. International Journal of Infectious Diseases, vol. 14, pp. e308-e310, 2010.
F. H. Wolff, S.. C. Fuchs and A. B. M. Brandão. “Absence of occult hepatitis B among blood donors in Southern Brazil”. The Brazilian Journal of Infectious Diseases, vol. 15, pp. 159-162, 2011.
R. N. Hassan and A. H. Hussain. “Hepatitis B virus DNA in blood donors positive of anti-hepatitis B core ntibodies and negative for surface antigen in Hawler major blood bank, Kurdistan Region, Iraq”. Journal of the Faculty of Medicine, Baghdad, vol. 60, pp. 57-61, 2018.
D. H. Seo, D. H. Whang, E. Y. Song, H. S. Kim and Q. Park. “Prevalence of antibodies to hepatitis B core antigen and occult hepatitis B virus infections in Korean blood donors”. Transfusion, vol. 51, pp. 1840-1846, 2011.
E. Zervou, G. Dalekos, D. Boumba and E. Tsianos. “Value of anti-HBc screening of blood donors for prevention of HBV infection: Results of a 3-year prospective study in Northwestern Greece”. Transfusion, vol. 41, pp. 652-658, 2001.
S. A. Awan, A. Junaid and S. Sheikh. “Transfusion transmissible infections: Maximizing donor surveillance”. Cureus, vol. 10, pp. e3787-e3787, 2018.
S. L. Stramer, S. Zou, E. P. Notari, G. A. Foster, D. E. Krysztof, F. Musavi and R. Y. Dodd. “Blood donation screening for hepatitis B virus markers in the era of nucleic acid testing: Are all tests of value”? Transfusion, vol. 52, pp. 440-446, 2012.
Copyright (c) 2020 Chato A. Taher, Goran N. Saleh
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors who publish with this journal agree to the following terms:
1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License [CC BY-NC-ND 4.0] that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).