Prevalence and screening costs of hepatitis C virus among Ugandan blood donors
Summary Background Screening donated blood for hepatitis C virus (HCV) is important for HCV prevention and is routinely practiced in North America and Europe. However, in many African countries little is known about HCV prevalence or cost‐effectiveness of HCV antibody (anti‐HCV) screening. Methods ...
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Veröffentlicht in: | Tropical medicine & international health 2006-06, Vol.11 (6), p.951-954 |
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Background Screening donated blood for hepatitis C virus (HCV) is important for HCV prevention and is routinely practiced in North America and Europe. However, in many African countries little is known about HCV prevalence or cost‐effectiveness of HCV antibody (anti‐HCV) screening.
Methods We investigated 2592 plasma specimens collected consecutively from blood donors in central Uganda in 1999. Routine screening by the blood bank included human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg), and syphilis. To assess HCV prevalence and cost‐effectiveness of testing, specimens were additionally tested for anti‐HCV IgG by enzyme immunosorbent assay (EIA). Specimens repeatedly reactive (RR) on EIA were tested with a recombinant immunoblot assay (RIBA).
Results Overall, 107 (4.1%) specimens were HCV EIA RR. Fifteen EIA RR specimens (0.6%, 95% confidence interval = 0.3–0.9%) were RIBA positive and 47 (1.8%) were RIBA indeterminate. Most (80%) RIBA‐positive specimens were non‐reactive for HIV, HBsAg, and syphilis. RIBA positivity was not associated with donor age, sex, number of donations, HIV, or HBsAg positivity. Costs of screening donors for anti‐HCV by using EIA were estimated at US$782 per potential transfusion‐associated HCV infection (exposure to RIBA‐positive blood) averted.
Conclusions Current screening tests for other infections are ineffective in removing HCV‐positive donations. Testing costs are considerable; cost‐effectiveness of identifying HCV‐infected donors will be critical in decision making about HCV screening in Uganda.
Données de base Le criblage du sang des donneurs pour le virus de l'hépatite C est important pour la prévention de la maladie et est pratiqué en routine en Amérique du nord et en Europe. Cependant, dans de nombreux pays africains, il y a peu de connaissance sur la prévalence de l'hépatite C ou sur le rapport coût‐efficacité du test de criblage pour les anticorps anti virus de l'hépatite C.
Méthodes Nous avons investigué 2592 spécimens de sang collectés consécutivement de donneur de sang dans le centre de l'Ouganda en 1999. Les tests de routine pratiqués dans la banque de sang sont pour le VIH, l'hépatite B (antigène de surface HbsAg) et la syphilis. Afin d'estimer la prévalence de l'hépatite C et le rapport coût‐efficacité du test, les spécimens ont aussi été testes pour les IgG anti hépatite C par un test enzymatique EIA. Les spécimens qui ont réagit avec l'EIA ont été aussi testés avec un test |
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ISSN: | 1360-2276 1365-3156 |
DOI: | 10.1111/j.1365-3156.2006.01643.x |