Hepatitis C Virus in Potential Blood Donors in Ibadan, Nigeria.

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1 Global Advanced Research Journal of Microbiology (ISSN: ) Vol. 1(9) pp , October, 2012 Available online Copyright 2012 Global Advanced Research Journals Full Length Research Paper Hepatitis C Virus in Potential Blood Donors in Ibadan, Nigeria. Afolabi A.Y.* 1, Abraham A. 2, Oladipo E.K. 1, Fagbami A.H. 1 1 Department of Medical Microbiology and Parasitology, College of Health Sciences, Ladoke Akintola University of Technology, Ogbomoso, Nigeria. 2 Department of Haematology, Blood Bank Unit, University College Hospital, Ibadan, Nigeria. Accepted 08 October, 2012 Hepatitis C Virus (HCV) is one of the agents of transmissible transfusion infection (TTI) and causes threat to blood safety for recipients. Blood transfusion is one of the pathway in which HCV is being transmitted. This study aimed to determine the seroprevalence of HCV among potential blood donors at Blood Bank of University College Hospital (UCH) Ibadan, Nigeria. Over a period of 6 month (February July, 2010) 507 consenting potential blood donors, were tested for anti-hepatitis C virus antibodies using a convenient sampling technique. Pre-test counselling sessions was done, before validated questionnaire was administered, for data collection and laboratory serological test was done. The mean age of the respondents was 32.7 ± 9.2 years. A total of 7(1.4%) were positive for anti-hcv. HCV prevalence was highest among age group of which is 4 (2.1%), females 2 (2.5%), students 3 (2.7%), tertiary level of education 4 (2.0%) and unmarried, 4 (2.1%).The rates were lower than the previous studies in Nigeria perhaps this is due to the public enlightment on transmissible transfusion infections. Keywords: HCV, Blood donors, UCH, Ibadan, TTI INTRODUCTION Infection with hepatitis C virus (HCV) is a major and growing public health problem, which could easily lead to chronic liver disease, cirrhosis and even hepatocellular carcinoma (Alter 2007). Hepatitis C virus infection is a common serious complication of blood transfusion. It is recognised as an important viral disease in the tropical countries and has become a major global public health problem (Perz Jet al., 2004). Hepatitis C is an infectious disease affecting the liver, caused by the Hepatitis C (HCV) (Ryan and Ray 2004). The infection is often asymptomatic, but once established, chronic infection can *Corresponding author s yettykay@yahoo.com progress to scarring of the liver (fibrosis), and advanced scarring (cirrhosis) which is generally apparent after many years. In some cases, those with cirrhosis will go on to develop liver failure or other complications of cirrhosis, including liver cancer (Ryan and Ray 2004) or life threatening oesophageal varices and gastric varices. The hepatitis C virus (HCV) is spread by blood-to-blood contact. Most people have few, if any symptoms after the initial infection, yet the virus persist in the liver in about 85% of those infected (Gao 2011). Persistent infection can be treated with medication, interferon, and ribavirin being the standard-of-care therapy. Those who develop cirrhosis or liver cancer may require a liver transplant, and the virus universally recurs after transplantation. The hepatitis C virus (HCV) is transmitted by blood-to-blood contact.

2 156. Glo. Adv. Res. J. Microbiol. Although injection drug use is the most common routes of HCV infection, any practice, activity, or situation that involves blood-to-blood exposure can potentially be a source of HCV infection. The virus may be sexually transmitted, although this is rare, and usually only occurs when an STD that causes open sores and bleeding is also present and it is estimated that Hepatitis C has infected nearly 200 million people worldwide, and infects 3-4 million more people per year (Liu and Wei 2007; Ruiz et al., 2002). However, hepatitis C is a systemic disease and patients may experience a wide spectrum of clinical manifestations ranging from an absence of symptoms to a more symptomatic illness prior to the development of advanced liver disease. The rapid global spread of HCV is believed to have occurred primarily because of efficient transmission through blood transfusion and parenteral exposures with contaminated equipment (Prati 2006). Blood donors, particularly those that rely on blood donation as a source of income, had a very high prevalence of HCV infection (Chen and Jiang 2009). The actual prevalence of HCV is difficult to assess because serological tests do not discriminate among acute, chronic, or resolved infection, and the analyzed groups in most countries are not representative of the general population, such as blood donors, drug users, or individuals with high-risk sexual practices (Lavanchy 2009; Chevaliez and Pawlotsky 2006).Therefore, this study was carried out in order to know the seroprevalence of HCV among potential blood donors at University Teaching Hospital, Ibadan. MATERIALS AND METHODS Study Centre The Study centre was located in Ibadan, Oyo State, situated in the tropical belt of Southern Western part of Nigeria. The study is at the Blood Bank of University College Hospital, Ibadan, Nigeria. Study Population The study participants were potential blood donors presenting at the blood bank of the University College Hospital, Ibadan between February and July Total of Five hundred and seven samples was collected from the prospective donors. Sample Collection (Blood) Samples were collected in a tube without anticoagulant. A tourniquet was firmly tied to the upper arm of the donor while sitting and skin sterilizer with 70% alcohol. The sterile needle was inserted into conspicuous antecubital vein and the plunger of the sterile syringe was withdrawn and pressure applied to the puncture site with a cotton wool to stop bleeding. Blood sample was spun on a bench centrifuge at 3,000rpm for 10 minutes to obtain serum. Serum or plasma was separated immediately. Data Collection and Laboratory Method A survey of the blood sample of the prospective donors at the Blood Bank, University College Hospital (UCH) Ibadan was conducted from February July 2010 using structured questionnaire. Descriptive statistics and correlation analysis was performed to check the relationship between the data and laboratory test results observed and inference was drawn using an inferential statistics (SPSS version 15). A cross-sectional study was conducted from February to July, 2010 at blood bank of the University College Hospital, (UCH) Ibadan. The total samples include all the donors, presenting and consented to participate during the study period. Prior to blood collection, the blood donors were required to answer questionnaire. After consent was obtained and pre-test counselling was done, and the questionnaire was completed, 5mls blood sample was collected in sterile tubes without anticoagulant from each study participant using a vacutainer needle. Serological examination was conducted on each sample. Serum samples were tested for HCV-Ab DIA.PRO ELISA made in Italy. RESULTS The results of tests for HCV antibody in the study population is shown in Table 1, out of the 507 sera tested for antibody to HCV 7(1.4%) were positive. The age distribution of HCV antibody test result in the study is shown in Table 2. The highest prevalence of HCV antibody (2.1%) was found in years age group. Prevalence of HCV antibody in the other age groups are as follows; years (1.5%) and years (0.8%). The gender distribution of the study participants tested for HCV antibody is shown in Table 1. Out of 426 males, 5(1.2%) were positive for HCV antibody and among the 81 females, 2 (2.5%) were positive for HCV antibody. The prevalence of HCV antibody is higher in females than male (p-value > 0.05), but the difference is also not statistically significant. Table 3 shows the prevalence of HCV antibody among the different occupational groups. The highest prevalence of HCV antibody 2.7% was found among students, followed by traders (1.9%). The prevalence of HCV antibody among civil servants and professionals was 1.6% and 1.3%, respectively. Prevalence of HCV antibody was

3 Afolabi et al. 157 Table 1. Gender distribution of Hepatitis C virus antibodies among the study participants. Gender Distribution Sex Total No Tested Total No Positive Prevalence % (95% CI) Male Female Total Table 2. Prevalence Hepatitis C virus antibodies among different age group of study Participant Age (In Years) Range Total No Tested Total No Positive Prevalence % (95% CI) Total Table 3. Prevalence of Hepatitis C Virus antibodies in different occupational groups. Occupational Groups Group Total No Tested Total No positive Prevalence % (95% CI) Unemployed Civil Servant Professional Artisan

4 158. Glo. Adv. Res. J. Microbiol. Table 3. Continue Trading Student Others Total Table 4. Prevalence of Hepatitis C Virus antibodies among study participant with different Level of education. Level of Education Educational Level Total No Tested Total No Positive Prevalence% (95% CI) Illiterate Primary Secondary Tertiary Quranic significantly higher among students than traders (P 0.05), civil servants (P > 0.05) and professional P Table 4 shows the prevalence of HCV antibody by level of their education. HCV antibody was found only in participants with secondary and tertiary education. Prevalence of HCV antibody was 2.0% among participants with tertiary education and 1.1% among those with secondary education. A total of 489 study participants with different marital status were tested for antibodies to HCV. The prevalence of HCV antibody in married and unmarried participants is shown in Table 5. Out of 297 married study participants, 3(1.0%) were positive of HCV antibody.out of 192 unmarried, 4(2.1%) were positive for HCV. HCV antibody was higher among the unmarried participants than in married individuals, the difference is statistically significant P > DISCUSSION Blood transfusion is the process of transferring blood or blood-based products from one person into circulatory system of another, to save lives in some medical conditions. Although blood transfusion saves million of lives worldwide each year, recipients of the blood or blood product transfusions stand the risk of becoming infected with blood-borne diseases such as hepatitis C virus (HCV), through transfusion of infected blood and blood products (UNAIDS women and AIDS 2007). In this study 507 donors were recruited into the study with ages ranging from age 16 years to 68 years. In general blood donors must fulfil certain requirements, one of which is the age requirement of between years. This explains why no study subject was below age 19 and only a few were above 60 years old. There was a predominance of males among the

5 Afolabi et al. 159 Table 5. Prevalence Hepatitis C Virus antibodies by marital status of the study participants Marital Status Status Total No Tested Total No Positive Prevalence % (95% CI) Married Unmarried Total study participants because females are not encouraged to donate blood in Nigeria society. Also, most of the replacement donors are men. Prevalence of antibody to HCV (2.1%) in this study was significantly higher among the unmarried participants than in married individuals. Higher prevalence values HCV antibody in unmarried may be due to the fact that the unmarried individuals are more likely to engage in behaviours that put them at risk of all these infections than the married participants. HCV antibodies found were 1.4%, this finding showed that hepatitis C viruses are circulating in Ibadan and infecting the residents of the city, including the blood donors. The seroprevalence of HCV antibody found among blood donors in this study is lower than that reported by previous workers. Fashola et al., showed the prevalence of HCV antibody among blood donors in UCH Ibadan was 4.96%. Studies carried out in other location in Nigeria also showed a higher prevalence of HCV antibody in blood donors than that found in this study. Isa et al., found HCV antibody prevalence of 1.8% among blood donors in Kaduna, Kaduna state, Nigeria. Studies carried out by Egah et al., in Jos, Plateau state, Nigeria showed that the prevalence of HCV antibody among blood donors was 6%. Chukwurah et al., and Ayolabi et al., also found higher prevalence of HCV antibody among blood donors. A study carried out in South-Eastern state of Nigeria, Chukwurah et al., found that 7.6% of blood donors had HCV antibody in their sera. In similar study carried out in Lagos, Nigeria Ayolabi et al., reported that 8.4% of blood donors were positive for HCV antibody. Overall, the prevalence of HCV antibodies found in this study is one of the lowest ever reported from Nigeria. This observation may probably be due to the positive impact of HIV education and public enlightenment campaign which have been in place in Ibadan and everywhere for many years, since HIV, and HCV have similar modes of transmission. REFERENCES Alter MJ (2007). Epidemiology of hepatitis C virus infection. World J Gastroenterol, 13: Ayolabi CI, Taiwo MA, Omilabu SA, Abebisi AO, Fatoba OM (2006). Sero-prevalence of Hepatitis C Virus among Blood Donors in Lagos, Nigeria. African J. Biotechnol., 5(20): Chen YT, Jiang JJ (2009). Epidemic situation of hepatitis C virus. Strait J.Preventive Med., 15:19-21, [in Chinese]. Chevaliez S, Pawlotsky JM (2006).Hepatitis C virus serologic and virologic tests and clinical diagnosis of HCV-related liver disease. Int J Med Sci, 3: Chukwurah EF, Ogbodo SO, Obi GO (2005).Seroprevalence of Hepatitis C Virus (HCV) among blood donors in South Eastern States of Nigeria. Biomedical research; 16, Egah, DZ, Mandong BM, Iya D, Gomwalk NE, Audu ES, Banwat EB, Onile BA,(2004). Hepatitis C Virus Antibodies among Blood Donors in Jos, Nigeria. Annals of Afr. Med., 3(1): Fasola F, Kotila T, Akinyemi JO (2008).Trends in Transfusion transmitted viral infections from in Ibadan Nigeria. Intervirology 51: Gao (2011). BMC Infectious Diseases, 11:88 page 8 of 14.Isa AH, Hassan A, Mamman AI (2009). Seroprevalence of hepatitis C virus antibodies among blood donors in Ahmadu Bello University Teaching Hospital, Kaduna. Afr. J. Cln. Exper. Microbiol.; 11: Lavanchy D (2009). The global burden of hepatitis C. Liver Int, 29(Suppl 1): Liu LJ, Wei L (2007). Epidemiology of hepatitis C virus. Infectious Disease Information, 20: , [in Chinese]. Perz JF, Farrington LA, Pecoraro C, Hutin YJF, Armstrong GL (2004).Estimated global prevalence of hepatitis C virus infection. 42nd Annual Meeting of the Infectious Diseases Society of America Boston: MA USA. Prati D (2006). Transmission of hepatitis C virus by blood transfusions and other medical procedures: a global review. J Hepatol, 45: Ruiz J, Molitor F, Plagenhoef J (2002). "Trends in hepatitis C and HIV infection among inmates entering prisons in California, 1994 versus 1999.". AIDS 16 (16): Ryan KJ, Ray CG (2004). Sherris Medical Microbiology (4th Ed.). McGraw Hill. pp UNAIDS women and AIDS: UNAIDS point of view UNAIDS. Geneva 2007.