The persistence of hepatitis C virus transmission risk in China despite serologic screening of blood donations
Article first published online: 19 JUN 2013
© 2013 American Association of Blood Banks
Special Issue: Thirty Years of Progress since Recognition of Transfusion-Associated AIDS
Volume 53, Issue 10pt2, pages 2489–2497, October 2013
How to Cite
Wang, J., Liu, J., Huang, Y., Wright, D. J., Li, J., Zhou, Z., He, W., Yang, T., Yao, F., Zhu, X., Wen, G., Bi, X., Tiemuer, M.-h.-l., Wen, X., Huang, M., Cao, R., Yun, Z., Lü, Y., Ma, H., Guo, N., Yu, Q., Ness, P., Shan, H. and NHLBI Retrovirus Epidemiology Donor Study-II (REDS-II) International Component (2013), The persistence of hepatitis C virus transmission risk in China despite serologic screening of blood donations. Transfusion, 53: 2489–2497. doi: 10.1111/trf.12297
- Issue published online: 4 OCT 2013
- Article first published online: 19 JUN 2013
- Manuscript Accepted: 5 MAY 2013
- Manuscript Revised: 3 MAY 2013
- Manuscript Received: 15 MAR 2013
A total of 2%-2.9% of the population in China is infected with hepatitis C virus (HCV). This study estimated the prevalence and incidence of HCV among Chinese 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, Johnson & Johnson) 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.
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.
High prevalence and incidence in donors indicate high residual risks for transfusion-transmitted HCV in Chinese patients. Implementation of minipool nucleic acid testing in routine donation screening may prevent a substantial number of transfusion-transmitted HCV infections.