Hepatitis B Versus Hepatitis C in Blood Donors

Introduction: Transmission of infectious diseases through donated blood is of concern to blood safety as transfusion forms an integral part of medical and surgical therapy. Blood transfusion carries the risk of transfusion-transmissible infections, including HIV, hepatitis, syphilis, malaria and infrequently toxoplasmosis. With every unit of blood, there is 1% chance of transfusion-associated problems including transfusion-transmitted diseases.Among all infections HIV and hepatitis are the most dreadful. Aims & Objectives: To find out the seroprevalence of hepatitis B virus and hepatitisC virus in blood donors , to determine the incidence of transfusion related disease in blood donors, to find the incidence of spectrum of diseases in blood bank donation, to find the age distribution of the cases studied and to find the sex distribution of the cases studied. Material & Methods: The present study is being undertaken in the Department of Pathology MGM Medical College Indore. This is a retrospective study that will be conducted, during the period 2008 –2013. Tests are routinely done on every blood unit to exclude HIV, HBV, HCV, syphilis and malaria. Donors were selected by the standard criteria for donor fitness. The screening for HIV was done by ELISA using kits. HBS Ag was detected by ELISA. Anti-HCV test was done by ELISA. Results: In the present study, 94721 blood donors are observed in the year 2008-13 in the M. Y. Blood Bank.Majority of donors are voluntary donors 76.25 % as compared to replacement/relative donors 23.74 %.Out of total 94721 blood donations, majority of donors are male donors 94.9 % (89900) as compared to female donors 5.08 % (4821).The seroprevalence of HBV&HCV is 1.83% & 0.07% respectively. Seroprevalence is higher in the age group 26-35 year for HBV (0.93 %). HCV (0.025 %) is prevalent higher in age group 18-25 year. Over all Seroprevalence of transfusion transmitted disease in all donations in the year 2008-13 is 1.91 %. Seroprevalence of transfusion transmitted disease is higher in voluntary donors 1.44 % as compared to replacement/relative 0.532 % donors. Conclusion: voluntary blood donation should be encouraged for prevention of transfusion-transmissible diseases. The time and cost involved in screening donated blood can be reduced by an effective donor education and selection program that promotes self-exclusion by donors at risk of transfusion-transmissible infections. Introducing nucleic acid testing (NAT) for HBsAg and HCV is recommended to detect the infection during window period.


Introduction
Transmission of infectious diseases through donated blood is of concern to blood safety as transfusion forms an integral part of medical and surgical therapy. Blood transfusion carries the risk of transfusion-transmissible infections, including HIV, hepatitis, syphilis, malaria and infrequently toxoplasmosis, Brucellosis and some viral infections like CMV, EBV and herpes.
With every unit of blood, there is 1% chance of transfusionassociated problems including transfusion-transmitted diseases.Among all infections HIV and hepatitis are the most dreadful. The first case of transfusion-associated AIDS was described in an infant given transfusion for erythroblastosis foetalis. There after, many cases were reported all over the world in which transfusion of blood and its products was the only risk factor.The improved screening and testing of blood donors has significantly reduced transfusion-transmitted diseases in most developed countries. This has not been so in developing nations. Poor health education and lack of awareness result in the reservoir of infections in the population.

Material and Methods
The present study is being undertaken in the Department of Pathology MGM Medical College Indore. This is a retrospective study that will be conducted, during the period 2008 -2013. Tests are routinely done on every blood unit to exclude HIV, HBV, HCV, syphilis and malaria. Donors were selected by the standard criteria for donor fitness. The screening for HIV was done by ELISA using kits. HBS Ag was detected by ELISA. Anti-HCV test was done by ELISA. 3. To find the incidence of spectrum of diseases in blood bank donation.

4.
To find the age distribution of the cases studied.

5.
To find the sex distribution of the cases studied.

Results
The present study is conducted in the Department of Pathology MGM Medical College Indore and M. Y. Hospital blood bank. This is a retrospective study that was conducted,

Discussion
There are four main groups of micro-organisms known to cause infections namely viruses, bacteria, protozoa and fungi. Only first three groups of microbes -viruses, bacteria and protozoa -have been reported to be transmitted by blood transfusion. Individuals with fungal infections are usually too sick to be accepted as blood donors. Viruses are most commonly transmitted by transfusion.
Recently, a new form of infectious agent -the prion -has been identified. At this time, there is no evidence to suggest that they could be transmitted by blood transfusion.
Viruses are the simplest forms of life. They infect all forms of life, they lack certain components needed to live and their growth hence depend on the host cell that they infect to provide these missing components.Following are some of the viruses which are known to be transmitted through blood: The transmission of HBV is mainly by parental route which involves direct contact with body fluid. The most common route of infection are: • Contact with infected blood, either by exposure of wounds to infected blood or to contaminated needles and syringes used in injecting drugs, tattooing, ear piercing, or acupuncture.
• Sexual contact • Neonatal or perinatal transmission • Transfusion of infected blood or blood products. 1 Hepatitis C is an infectious disease affecting primarily the liver, caused by the hepatitis C virus (HCV). [8] The infection is often asymptomatic, but chronic infection can lead to scarring of the liver and ultimately to cirrhosis, which is generally apparent after many years. In some cases, those with cirrhosis will go on to develop liver failure, liver cancer or life-threatening esophageal and gastric varices. 9 HCV is spread primarily by blood-to-blood contact associated with intravenous drug use, poorly sterilized medical equipment and transfusions. Hepatitis C only infects humans and chimpanzees. 10 Hepatitis C is the leading cause of liver transplantation, though the virus usually recurs after transplantation. 11 No vaccine against hepatitis C is available.

Summary and Conclusion
The present study is conducted in the Department of Pathology MGM Medical College Indore and M. Y. Screening and better selection of donors are necessary to improve blood safety in the regional blood transfusion centre of M. Y. Hospital. Therefore, it is concluded that voluntary blood donation should be encouraged for prevention of transfusion-transmissible diseases. The time and cost involved in screening donated blood can be reduced by an effective donor education and selection program that promotes self-exclusion by donors at risk of transfusion-transmissible infections. Introducing nucleic acid testing (NAT) for HBsAg and HCV is recommended to detect the infection during window period.