BACKGROUND: Human Immunodeficiency Virus and Hepatitis B virus are blood borne pathogens that can be transmitted through blood transfusion and could pose a huge problem in areas where mechanisms of ensuring blood safety are suspect. This study became necessary in a population where most of the blood for transfusion is from commercial blood donors. METHOD: A total of 130 donors comprising 120 commercial donors and 10 voluntary donors were tested for antibodies to human immunodeficiency virus and hepatitis B surface antigen in Benin city using Immunocomb HIV - 1 and 2 Biospot kit and Quimica Clinica Aplicada direct latex agglutination method respectively. RESULTS: Thirteen (10%) samples were HIV seropositive and 7(5.8%) were HBsAg positive. The age bracket 18 – 25years had the highest numbers of donors and also had the highest number of HBsAg positive cases (7.8%) while the age group 29 – 38years had highest number of HIV seropositive cases. CONCLUSION: High prevalence of HIV antibodies and Hepatitis B surface antigen was found among commercial blood donors. Appropriate and compulsory screening of blood donors using sensitive methods, must be ensured to prevent post transfusion hepatitis and HIV

Okoror, Lawrence Ehis

Orhue, Philip

Umolu, Patience Idia

PubMed

Background: Human Immunodeficiency Virus and Hepatitis B virus are blood borne pathogens that can be transmitted through blood transfusion and could pose a huge problem in areas where mechanisms of ensuring blood safety are suspect. This study became necessary in a population where most of the blood for transfusion is from commercial blood donors.
Method: A total of 130 donors comprising 120 commercial donors and 10 voluntary donors were tested for antibodies to human immunodeficiency virus and hepatitis B surface antigen in Benin city using Immunocomb HIV - 1 and 2 Biospot kit and Quimica Clinica Aplicada direct latex agglutination method respectively.
Results: Thirteen (10%) samples were HIV seropositive and 7(5.8%) were HBsAg positive. The age bracket 18 – 25years had the highest numbers of donors and also had the highest number of HBsAg positive cases (7.8%) while the age group 29 – 38years had highest number of HIV seropositive cases.
Conclusion: High prevalence of HIV antibodies and Hepatitis B surface antigen was found among commercial blood donors. Appropriate and compulsory screening of blood donors using sensitive methods, must be ensured to prevent post transfusion hepatitis and HIV.
African Journal of Health Sciences Vol.5(1) 2005: 55-5

AJOL - African Journals Online

African Health Sciences Vol 5 No 1 March 2005 55Human immunodeficiency virus (HIV) seropositivity andhepatitis B surface antigenemia (HBSAG) among blooddonors in Benin city, Edo state, NigeriaPatience Idia Umolu, Lawrence Ehis Okoror  and Philip OrhueDepartment of  Microbiology, Faculty of  Natural Sciences, Ambrose Alli University, Edo State, NigeriaINTRODUCTIONAcquired immune deficiency syndrome isa life threatening complication of  HIV, which is aretrovirus having two strains namely; HIV 1 and211. Sub Saharan Africa has been severely hit by theHIV/AIDS pandemics11. HIV is now the leadingcause of death in Africa replacing malaria and othercommunicable diseases.Hepatitis B viral infection is one of theworld most fatal malignancies. There have been fearsabout hepatitis B vaccine in AIDS transmission andHadler et, al.,4. Postulated that infection with theHuman immunodeficiency virus might alter theimmune response to hepatitis B vaccine.Hepatitis B virus and HIV are know to betransmitted through sexual intercourse, blood andblood products, shared needle, other body fluidssuch as semen, virginal fluid and breast milk6,12. Dueto the risk of transmission of HIV through breastmilk, many mothers have been advised not to breastfeed7. However, recent research has shown thatexclusive breastfeeding for 3 months results in lesstransmission than artificial feeding8.In Nigeria, the prevalence of  HBsAg in normalpopulation ranges from 2.7% to 13.3%9 – 11.The epidemiology of  human immunodeficiencyvirus infection has been described in detail by manyworker15, 6. Over the years, the rise from 2 in 1986 to 436in 1992 and by December 1995, 5,201 cases had beenreported to the national STD/AIDS control program13.But today, it is estimated that about 6million people arealready infected with AIDS virus although the officialrecords put the population of those infected with HIV inNigeria at 2.5million. Everyday records also show that byDecember 1998, 1,000,000 Nigerians were already livingwith AIDS or already killed by it and 9 of every 10 casesof HIV infection occur through sex15.Human immunodeficiency virus and hepatitis Bvirus infections are two major viral infections worldwide.The presences of infection markers to these two virusesin blood donors obviously present great risk to recipient.In this study we report the prevalence HIV seropositivityCorrespondence to:Dr. Idia P. UmoluDepartment of  microbiology,Faculty of  Natural Sciences,Ambrose Alli University,P.M.P 14, Ekpoma, Edo State, Nigeria.Larison86@yahoo.comand Hepatitis B surface antigenemia in blood donors inorder to ensure that proper screening of blood and bloodproducts in the population sampled are effected, it is alsoaimed at ensuring proper counseling of  blood donor.ABSTRACTBackground: Human Immunodeficiency Virus and Hepatitis B virus are blood borne pathogens that can be transmittedthrough blood transfusion and could pose a huge problem in areas where mechanisms of ensuring blood safety are suspect. Thisstudy became necessary in a population where most of the blood for transfusion is from commercial blood donors.Method: A total of 130 donors comprising 120 commercial donors and 10 voluntary donors were tested for antibodies to humanimmunodeficiency virus and hepatitis B surface antigen in Benin city using Immunocomb HIV - 1 and 2 Biospot kit and QuimicaClinica Aplicada direct latex agglutination method respectively.Results: Thirteen (10%) samples were HIV seropositive and 7(5.8%) were HBsAg positive. The age bracket 18 - 25years had thehighest numbers of donors and also had the highest number of HBsAg positive cases (7.8%) while the age group 29 - 38yearshad highest number of HIV seropositive cases.Conclusion: High prevalence of HIV antibodies and Hepatitis B surface antigen was found among commercial blood donors.Appropriate and compulsory screening of blood donors using sensitive methods, must be ensured to prevent post transfusionhepatitis and HIV.African Health Sciences 2005; 5(1): 55-58African Health Sciences Vol 5 No 1 March 2005 56MATERIALS AND METHODSA total of 130 blood samples werecollected by venal puncture into sterile vacutainiersfrom blood donors in Benin City. The red bloodcells were used for ABO typing while the sera werecollected aseptically after centrifugation at 3000rpmfor ten minutes into sterile containers and preservedat -200C until tested for the presence of HBsAgand antibody to HIV. Prior to testing the sera wereallowed to attain room temperature.For the detection of  Hepatitis B surfaceantigenemia, Quimica Applicada kits were used asdescribed by the manufacturers. Antibodies tohuman immunodeficiency virus or HIVseropositivity were determined using immuncombII HIV 1 and 2 Biospot kit.RESULTSA total of 130 apparently healthy blood donorswere screened for antibodies to human immunodeficiencyvirus (HIV), and hepatitis B surface antigen (HBsAg) usingthe immunocmb II HIV 1 and 2 Biospot and the QuimicaClinical Aplicada direct latex aggulation respectively. Ten(7.70%) were voluntary donors while 120 (92.3%) werecommercial donors.Table 1 reflects the carrier rate of  HIV antibodiesand HBsAg among the blood donors with 13 (10%) beingpositive for HIV antibodies and 7 (5.4%) were positivefor HBsAg. Of  the total positive cases, eleven had HIV –1 strain, one had HIV – 2 strains, one had both HIV 1and 2 (Table 2).Table 1: Distribution of  HIV antibodies and HBsAg among blood donors.Number positive                 percentage positiveSex No. Screened HIV HBsAg HIV HBsAgMales 129 13 7 10.1 5.4Females 1 - - - -Total 130 13 7 10% 5.4Table 2: Distribution of  types of  HIV antibodies with age.Age years No. of samples HIV-1 strains HIV-2 strains HIV-1& 2 strains18 – 28 77 7 - -29 – 38 43 4 1 139 – 48 6 - - -49 – 58 4 - - -59 – 68 - - - -Total 130 11 1 1The blood group O had the highest number of donors and 9 (10.3%) and 4 (4.8%) positive cases for HIVantibodies and HBsAg respectively. The AB blood group had no donors (Table 3).Table 3: Distribition of  HIV antibodies and HBsAg. Among ABO blood donors screened.ABO blood        A                        B                                 AB                            OHIV      HBsAg       HIV      HBsAg     HIV       HBsAg     HIV       HBsAgNo. screened 25 25 18 18    -      - 87 87No. screened 2 - 1 2    -      - 9 4Percentage of carriers 8 - 5.6 11.1    -      - 10.3 4.6African Health Sciences Vol 5 No 1 March 2005 57The rate of occurrence was found to be higher among the group 18 – 28, 6 (7.8%) for HBsAg and 29 – 38 had6 (14%) for HIV (Table 4).Table 4:   Distribution of  HIV antibodies and HBSAG with age among blood donors.Age (years) 18 - 28 29 - 38 39 - 48 49 - 58 59 - 68No. of  donors 77 43 6 4 -No. with HIV 7 6 - - -No. with HBsAg 6 1 - - -Percentage of HIV positive 9.1 14 - - -Percentage of HBsAg positive 7.8 2.3 - - -DISCUSSIONThe prevalence of HIV antibodies andhepatitis B surface antigen in blood to be transfusedto recipient who by virtue of his/her compromisedhealth status (e.g. anemia or surgery) is thoughtprovoking and leaves room for serious concern.Most people infected by these viruses haveno symptoms and do not know that they carry thevirus, but all who are infected can transmit the virusto others15, 16. This is further compounded in casesof donors, in that after testing positive to the viruses,counseling is withheld as it is thought that it mayfrustrate donors and lower the blood pool. Theeffect of this action is that, those uncounselledseropositive donors are innocently infecting thesociety17.In Nigeria, the prevalence of HBsAg rangefrom 6 – 11% among blood donors10. Furtherresearch on the incidence of HBsAg in the NorthernNigeria blood donors, revealed that 8.9% of 1860blood donors tested were positive19. This studyrevealed a prevalence rate of 5.4% among blooddonors in Benin City, which is lower than the resultobtained in Northern Nigeria. However, there couldbe a steady rise in the infection rate when consideringthe rate at which the youths who form the bulk ofdonor engage in indiscriminate sex. The lack ofinterest in protected sex (use of condoms) may bea factor that could lead to the steady rise of infectiondue to both viruses. So there should be a creationof enough awareness by those involved informulating policies on blood donation andeveryone interested in building a safe society.Among the 130 donors screened for HIVusing immunocomb II HIV 1 and 2 Biospot, atotal of 13 (10%) was found to be positive, theywere confirmed with immunocomb Firm. Elevenout of the 13 positive cases had HIV 1 as compared toHIV 2, one had HIV 1 and 2 the high increment in HIV 1as compared to HIV 2 is as a result of high social habitsof  individuals. Simultaneous presence of  antibodies to HIV1 and HIV 2 was observed in this study. This is in harmonywith what was observed by DeCock and BrunVezinet5.Okolie17 stated that HIV is on the increase in Benin City.Since the predisposing factors to HIV are similar to thoseof hepatitis B virus, hepatitis B virus infection could alsobe on the increase.Though no relationship exist between hepatitis Bsurface antigen and human immunodeficiency virus withABO blood group9, 20. The study showed that most donorswere group O and subsequently had the highest HBsAgand HIV seroposititvity prevalence rate.The high rate of infection noticed in commercialdonor may not be unconnected with lack of awareness,since most of the commercial blood donors in this partof the world are actually those from low socio-economicclass where the campaign against these dreaded diseasesare limited. They still engage in indiscriminate unprotectedsex and drug addiction, which could even, be a factor towhich they decided to be commercial blood donors. Theywill need money to maintain their life style (sex and drugs).And it has earlier been reported that sex remains a majortransmitter of both viruses in this part of the world14.Hence extra care should be taken when it comes to bloodfrom commercial donors. The apparent lack of  incidencein voluntary donors could be due to the fact that they arestable and probably aware of the HIV / hepatitis scourge.This does not mean that voluntary donors are not carriersbut the prevalence is low, as some may also be involved inindiscriminate sex and drug addiction12.  However, theinvolvement of voluntary blood donor is not conclusivein this study, since the number of  voluntary blood donorsscreened is statistically insignificant using the student t testat 95% confidence limit (ten as against 120 for commercialblood donors).African Health Sciences Vol 5 No 1 March 2005 58The age range of 18 – 28 had the highestnumber of positive cases for HBsAg while 29 – 38had the highest number of positive cases for antibodiesto HIV. Hepatitis B surface antigenemia HIV werehigher in the younger age than in the older age groupsand this younger age group (18-28) is the adolescentage involved in active sexual activity. This is harmonywith the report of  Awosere et, al.1. The fact that agegroup 29-38 had the highest seropositivity to HIVdoes not rule out more of the infection in youngerage group 18-28 as most of older people may havecontacted the infection in their younger active sexualage. UNAIDS correlates that in Africa, AIDS, will bethe cause of death of 50% of people now in theirteens. The age of  peak infection with HIV and HBsAgcorrelates well with the age of  greatest sexual activity,supporting the role of sex in the transmission of HIVand hepatitis B virus.Patients co-infected with HIV and HBV havea high progression to hepatic fibrosis and 3.5 foldincreases in hepatic cirrhosis when compared with HIValone22. Co-infection with HIV and HBV could alsoincrease hepatic cirrhosis and carcinoma. The highincidence of HBV may not be due to HIV infectionwhich has caused a reduction in the immunity of thepopulation in general.Although blood transfusion is not thought asa significant mode of transmission, blood transfusionwhere mechanisms of ensuring blood surety aresuspected, HIV and HBV is prevalent in thecommunity, and where many transfusions areconducted (sometimes needlessly), the problem canbe high. There is also problem of the ‘window period’when the antigens or antibodies are not yetdemonstrable; the blood can still transmit theinfection3.The possibility of such transmission can beminimized by selecting donors at low risk of HIVand HBsAg infection and by screening blood for thepresence of  HIV antibodies and HBsAg. A singlepolymerase chain reaction assay that screen forhepatitis C virus, hepatitis B virus and humanimmunodeficiency virus in a single assay is nowavailable. African governments should try and makethese kits available since it will aid in the diagnosis ofthese deadly viral infections since it has been notedthat PCR can reduce the window period of HIV by11days. These viruses remain the greatest public heathproblem as of  today.REFERENCES1. Awosere KE, Arinola OG, Uche LN. Hepatitis B virusseroprevalence among pregnant women in UCHIbadan. J Med Lab Sc. 1999; 8:77 –82.2. Abiodun PO, Ihongbe JC, Ubaru R, Krauledath P. HBsAgcarrier rate among the adult population in Benin City. PublicHealth 1986; 100: 362 – 367.3. Alabi G. Comments. African Health. 1999; 22(1):13.4. Coleman JK. Incidence of HBsAg in blood donors Am JEpidemio. 1989; 98 (2): 104 – 110.5. DeCock KM and Brun – Vezinet F. Epidemiology of  HIV-2 infection. AIDS. 1989; 3: 5896. Gallo RC, Salehuddin SZ, Popovic M. Frequent detectionand isolation of crytopathic retroviruses (HTLV3) frompatients with AIDS and at risk from AIDS. Science. 1984;224: 500 – 503.7. Hadler SC, Francis DP and Mayanard JE. Long termimmunogenicity and efficacy of hepatitis B vaccine inhomosexual men. N Engl J Med. 1986; 315: 2098. Hollinger FH. Hepatitis B virus In: Field Virology (Eds) Fields,B.N and Knipe 2nd  edition Raven press NY. 1990; 2171 –2263.9. Kulkarmi S Alowola FO and Wayo GG. Prevalence of  hepatitisB surface antigen in Northern Nigeria blood donors Vox-Sangunis. 1986; 50: 151 – 153.10. Lewkonia RM and Roland T. ABO blood groups distributionin serum hepatitis Brit Med J. 1969; 3: 268 – 269.11. Muula AS. Tackling HIV/AIDS in Africa – anotherperspective. Africa Health. 2000; 23(1): 5 – 6.12. Murray PR, Baron EO, Pfaller MA, Tenover FC and Yolken,RA. Hepatitis Manual of Clinical Disease and Diagnosis.American Society of  Science, New York (Publishers) 1995;425.13. Mandara M An Africa confab on AIDS/STDS opens inGhana. The Guardian News papers. Wednesday June 16th 1999page 12.14. Nasidi A, Harry TO, Vyazor, S.O., Munube, G.M.R., Azzan,B.B. and Ananiev, V.A. Prevalence of  hepatitis B infectionmarkers in two different geographical areas of Nigeria. Int.Conf. Viral Bacterial Vaccem. Inst Pasteur Prod. 1983; 1: 213.15. Nwoye A. The Concept of HIV/AIDS. Counseling andNutritional Therapy. FAB Educational Books Jos. 1994; 541 –545.16. Nelson CG., Iler MA, Woods CW, Bartlett JA, Fowler Jr VG.Meningococcemia in a patient coinfected with hepatitis C virusand HIV. Emerg infect Dis. 2000; 6(6): 646 – 648.17. Okolie MN. Seroeidemiological survey of  HIV staindistribution in Edo State and Delta State. Ph.D ThesisUniversity of  Benin, Benin City, Nigeria. 1997; 264.18. Onile BA. Acquired immunodeficiency syndrome (AIDS) inNigeria. Trop J Health Sc: 1994; 1: 1 – 6.19. Tribedi EB. Austrialia antigen in blood donors in Zaria. NigMed J.1994; 4(2): 127.20. UNICEF, UNAIDS and WHO. HIV and infant feeding:Guidelines for decision makers. UNICEF / UNAIDS /WHO / (WHO / FRH / UNT 98.1, UNAIDS/98.3) 1998,Geneva.21. World Health Organization. Guidelines for nursingmanagement of  people infected with HIV. Bull. World HealthOrgan. 1998; 143(1): 11 – 13.22. Walley J and Nicoll A. Preventing mother to childtransmission of HIV African Health. 2001; 23(2): 14.

English

Human immunodeficiency virus (HIV) seropositivity and hepatitis B surface antigenemia (HBSAG) among blood donors in Benin city, Edo state, Nigeria

Background:  Human Immunodeficiency Virus and Hepatitis B virus are
blood borne pathogens that can be transmitted through blood transfusion
and could pose a huge problem in areas where mechanisms of ensuring
blood safety are suspect. This study became necessary in a population
where most of the blood for transfusion is from commercial blood
donors.  Method:  A total of 130 donors comprising 120 commercial
donors and 10 voluntary donors were tested for antibodies to human
immunodeficiency virus and hepatitis B surface antigen in Benin city
using Immunocomb HIV - 1 and 2 Biospot kit and Quimica Clinica Aplicada
direct latex agglutination method respectively.  Results: Thirteen
(10%) samples were HIV seropositive and 7(5.8%) were HBsAg positive.
The age bracket 18 - 25years had the highest numbers of donors and also
had the highest number of HBsAg positive cases (7.8%) while the age
group 29 - 38years had highest number of HIV seropositive cases. 
Conclusions:  High prevalence of HIV antibodies and Hepatitis B surface
antigen was found among commercial blood donors. Appropriate and
compulsory screening of blood donors using sensitive methods, must be
ensured to prevent post transfusion hepatitis and HIV

Patience Idia Umolu

Lawrence Ehis Okoror

Philip Orhue

University of Toronto Research Repository

Human immunodeficiency virus (HIV) seropositivity and hepatitis B
surface antigenemia (HBSAG) among blood donors in Benin city, Edo
state, Nigeria

TSpace Repository

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1831904

Human immunodeficiency virus (HIV) seropositivity and hepatitis B surface antigenemia (HBSAG) among blood donors in Benin city, Edo state, Nigeria

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University of Toronto Research Repository

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