Premium
An assessment of hepatitis B virus prevalence in South African young blood donors born after the implementation of the infant hepatitis B virus immunization program: Implications for transfusion safety
Author(s) -
Vermeulen Marion,
Swanevelder Ronel,
Van Zyl Gert,
Lelie Nico,
Murphy Edward L.
Publication year - 2021
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.16559
Subject(s) - medicine , hepatitis b virus , odds ratio , incidence (geometry) , population , hepatitis b , blood transfusion , cohort , residual risk , hbsag , pediatrics , immunology , virology , virus , environmental health , physics , optics
Background The prevalence of hepatitis B surface antigen is estimated to be 6.7% in the South African population and in April 1995 the nation introduced universal hepatitis B virus (HBV) vaccination for newborns and infants. We studied the temporal association of this program with HBV prevalence in young blood donors and the contemporary HBV incidence and residual risk of transfusion‐transmitted HBV infection (TT‐HBV). Methods We used blood donation data from January 2011 to December 2019. Estimation of HBV prevalence donations made by first‐time blood donors were analyzed by birth cohort and covariates. To estimate the incidence and residual risk of TT‐HBV, mathematical models used data from both first time and repeat donors. Results HBV prevalence in first‐time donors decreased from 0.84% (95% confidence interval [CI] 0.78–0.90) in 2011 to 0.66% (95% CI 0.61–0.70) in 2019. The post‐1995 birth cohort had a significantly lower HBV prevalence of 0.14% (95% CI 0.13–0.15) than the pre‐1985 birth cohort of 1.29% (95% CI 1.25–1.33) and the odds of HBV infection were reduced in a multivariable model (odds ratio [OR] = 0.28, 95% CI 0.24–0.34). The residual risk of TT‐HBV occurring from window‐period, occult, and possible vaccine breakthrough infections were estimated at 36.9, 5.8, and 2.2 per million red blood cell transfusions, respectively. Conclusion Donors born after the start of routine HBV immunization had significantly lower prevalence of HBV infection, supporting the effectiveness of the vaccination program. The contemporary residual risk of TT‐HBV has decreased and should decline further as more vaccinated young people join the donor pool.