Hepatitis B and hepatitis C prevalence among blood donors in Northern-Central

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N N EE 1 2 3 3 4 4 DD EE II VV CC EE M. Karcheva , S. Mihaylova , A. Surdzhiyska , N. Doseva , K. Hristova , K. Koleva AA LL L PP L -- 1 2 3 UUNN YY IIVVEERRSSIITT Epidemiology, Medical University, , Bulgaria; Microbiology and Virology, Medical University, Pleven, Bulgaria; Immunology, Pleven Regional Blood Transfusion Centre, Pleven, Bulgaria; 4Medical Colleague, Medical University, Pleven, Bulgaria

Introduction Results

The Bulgarian blood service consists of five During the period of six years, 1,796 independent bodies: one national centre acting as the HBsAg-positive blood donors (1.51%) methodological body and four regional centres, one of and 228 blood donors with HCV- which is in Pleven (fig. 1). Testing for four transfusion infection (0.20%) were registered. The transmissible microorganisms: Hepatitis B virus mean ages of positive individuals were (HBV); Hepatitis C virus (HCV); Human 38 years (range 18-64 years) and 37 Figure 2. Age and gender distribution immunodeficiency virus (HIV); and Treponema years (range 19-66 years), for hepatitis of blood donors with hepatitis B. pallidum; is mandatory for all donated units. Screening B and C, respectively. The gender ratios

for hepatitis B among blood donors is carried out by (male/female) were 4/1 and 3/1, for virus surface antigen detection while screening for Figure 1. Map of Bulgaria divided into hepatitis B and C, respectively (fig. 2 5 donor regions. hepatitis C is by antigen-antibody detection. This study and 3). Regional differences in was done to determine the prevalence of HBV and seroprevalence were observed. The HCV markers among blood donors in Northern-Central highest rate of hepatitis B was in Bulgaria. (2.30%) and the lowest in Gabrovo (1.06%). The highest rate of hepatitis C was in (0.29%) and Materials and Methods Figure 3. Age and gender distribution the lowest in Pleven (0.12%) (fig. 4). of blood donors with hepatitis C. A total of 119,258 blood samples from voluntary donors were examined during the period, Co-infection with HIV was not 01.11.2007-31.10.2013. Blood donors were citizens of six districts (Pleven, Lovech, Gabrovo, observed. Two HBsAg-positive , Ruse, Razgrad) in Northern-Central individuals were also positive for Bulgaria. Each sample was tested three times, using antibodies against T. pallidum. HBsAg- Monolisa® HBsAg Ultra and Monolisa® HCV Ag-Ab Ultra c a r r i a g e a n d H C V- i n f e c t i o n (Bio-Rad). The Monolisa® HBsAg Ultra Confirmatory (Bio- demonstrated a decreasing trend line Rad) test was used to validate the presence of hepatitis B from 2007 to 2013.

surface antigen (HBsAg) in samples of human sera found reactive by the Monolisa® HBsAg Ultra screening test. Figure 4. Regional differences in HBV and HCV seroprevalence. Conclusions References 1. European Centre for Disease Prevention and Control. Hepatitis B and C in the EU neighbourhood: prevalence, burden of disease and screening · The prevalence of HBsAg among blood donors in Northern-Central Bulgaria is medium (>1% and ≤2%) and the prevalence policies. Stockholm: ECDC; 2010. 2. European Centre for Disease Prevention and Control. Surveillance and prevention of hepatitis B and C in Europe. Stockholm: ECDC; 2010. of HCV capsid antigen and/or anti-HCV antibodies among the same target population is low (≤1%). 3. Yordanova, V., S. Bakalova, K. Zlidolska. Prevention of viral hepatitis transmission through blood transfusions. Viral Hepatitis Prevention Board Meeting, , Bulgaria, March 24-25, 2011. · HBV/HCV prevalence estimates in first time blood donors are lower than those for the general population in Bulgaria (1, 2). 4. Kojouharova, M., P. Teoharov, N. Vladimirova, S. Zlatev, I. Haydushka, M. Atanasova, M. Sredkova, V. Grigorova, P. Sotirova, H. Djeneva, B. · The obtained results confirm the data of previous studies that the distribution of HBV and HCV infections is unequal in the Dimitrova, V. Rusev, L. Ivanova. Seroepidemiological study on hepatitis B infection prevalence in Bulgaria. P1315. 12th European Congress of Clinical Microbiology and Infectious Diseases, Milan, Italy, April 24-27, 2002. different age/gender groups as well as in the different areas of the country (3, 4). 5. Stramer, S. L., U. Wend, D. Candotti, G. A. Foster, F. B. Hollinger, R. Y. Dodd, J.-P. Allain, W. Gerlich. 2011. Nucleic acid testing to detect HBV · Blood safety would be improved if nucleic acid testing for HBV DNA and HCV RNA are applied to individual donations (5). infection in blood donors. N Engl J Med 364, 3, 236-247.