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The persistence of hepatitis C virus transmission risk in C hina despite serologic screening of blood donations
Author(s) -
Wang Jingxing,
Liu Jing,
Huang Yi,
Wright David J.,
Li Julin,
Zhou Zhongmin,
He Weilan,
Yang Tonghan,
Yao Fuzhu,
Zhu Xiangming,
Wen Guoxin,
Bi Xinhong,
Tiemuer Meiheili,
Wen Xiuqiong,
Huang Mei,
Cao Ru'an,
Yun Zhongqiao,
Lü Yunlai,
Ma Hongli,
Guo Nan,
Yu Qilu,
Ness Paul,
Shan Hua
Publication year - 2013
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.12297
Subject(s) - medicine , serology , hepatitis c virus , incidence (geometry) , immunology , logistic regression , hepatitis c , population , antibody , virology , virus , environmental health , physics , optics
Background A total of 2%‐2.9% of the population in C hina is infected with hepatitis C virus ( HCV ). This study estimated the prevalence and incidence of HCV among C hinese blood donors. Study Design and Methods We examined whole blood and apheresis platelet donations at five Chinese blood centers in 2008 to 2010. All donations were screened using two rounds of testing for alanine aminotransferase, antibody to human immunodeficiency virus Types 1 and 2, hepatitis B surface antigen, anti‐ HCV , and syphilis. Screening reactivity is defined by a reactive result in one or both rounds of screening tests. Confirmatory tests (Ortho third‐generation HCV enzyme immunoassay, J ohnson & J ohnson) were performed on anti‐ HCV screening–reactive samples. Confirmatory positive rates among first‐time donors (prevalence) and repeat donors (incidence) were calculated by blood center and demographic categories. Donor characteristics associated with HCV confirmatory status among first‐time donors were examined using trend test and multivariable logistic regression analysis. Results Among 821,314 donations, 40% came from repeat donors. The overall anti‐ HCV screening–reactive rate was 0.48%. Estimated HCV prevalence was 235 per 100,000 first‐time donors; incidence was 10 per 100,000 person‐years in repeat donors. In multivariable logistic regression analysis, first‐time donors older than 25 years displayed higher HCV prevalence than the younger donors. Less education is associated with higher HCV prevalence. Donors 26 to 35 years old and those above 45 years displayed the highest incidence rate. Conclusion High prevalence and incidence in donors indicate high residual risks for transfusion‐transmitted HCV in C hinese patients. Implementation of minipool nucleic acid testing in routine donation screening may prevent a substantial number of transfusion‐transmitted HCV infections.