Safe Blood Transfusion: Screening for Hepatitis B and Hepatitis C Virus Infections in Potential Blood Donors in Rural Southeast Asia

Abstract

2,400 blood samples from potential voluntary rural blood donors in a multicentre cross-sectional study in Cambodia and Vietnam were analysed with rapid and EIA tests for detection of HBsAg, anti-HBc and anti-HCV at local laboratories. 640 randomly selected blood samples were blindly validated in a Norwegian accredited micro-laboratory by a chemiluminescent micro particle immunoassay technique (CMIA). Rapid test for donor screening of hepatitis proved to have far lover accuracy than claimed by the manufacturer; especially the false-negative rate was unacceptably high. The study revealed that hepatitis B infection is endemic in rural Vietnam and almost half of Vietnamese population is or has been infected with hepatitis B while hepatitis C infection is rare. The results indicate that the EIA performance in blood donor screening in Vietnam may be sub-optimal. The major risk factors for post- transfusion hepatitis infection are HBsAg false-negative results and potential occult hepatitis B infections. Increased test sensitivity and locally validated HBsAg assays are recommended.