Prevalence and factors associated with transfusion-transmissible infections (HIV, HBV, HCV and Syphilis) among blood donors in Gabon: Systematic review and meta-analysis.

BACKGROUND: Transfusion-transmissible infections (TTIs) remain a major public health problem in countries with limited resources, particularly in Gabon. Complete information on the prevalence in Gabon of the main TTIs among blood donors is still lacking in the national context. The purpose of this systematic review and meta-analysis was to determine the prevalence and factors associated with TTIs among blood donors in Gabon. METHODS: This systematic review and meta-analysis was reported in accordance with the PRISMA 2020 guidelines. It was the result of data from several comprehensive studies published between 2014 and 2022, the purpose of which focused on the prevalence and factors associated with TTIs among blood donors in Gabon. The quality of the articles was assessed using the Joanna Briggs Institute critical appraisal checklist for studies reporting prevalence data. The overall prevalence of TTIs among blood donors was determined using the random effects model. Heterogeneity between studies was assessed using I2 statistics. Publication bias was assessed by visual inspection of the funnel plot and Egger's statistics. RESULTS: A total of 175,140 blood donors from the nine eligible studies were admitted to this study. The combined prevalence of HIV, HBV, HCV and syphilis obtained in the random effects model was 3.0%, 6.0%, 4.0% and 3.0%, respectively. Moreover, being a male blood donor and aged between 25 and 44 years was significantly associated with HBV infection and being a female blood donor and aged 35 years and over was significantly associated with HIV infection. Family or replacement blood donors had a high infection burden for all four TTIs of study. CONCLUSION: The overall prevalence of transfusion-transmissible infections remains high in the country's blood banks. Improving current prevention (selection criteria) and screening strategies may be necessary in a global approach.

Current Resistance of HIV-1 Strains Isolated in Volunteer Blood Donors in Gabon.

Detection of drug resistance mutations (DRMs) and HIV-1 subtypes ensures effective therapeutic management for HIV-infected individuals. In Gabon, data on DRMs are very little available in the population of people living with HIV and also among voluntary HIV-positive blood donors. This study aimed to study subtypes and DRMs in HIV-1-positive volunteer blood donors in Gabon. A cross-sectional study was carried out at the National Blood Transfusion Center of Gabon. A purposive sampling method was used to collect 128 HIV-1 seropositive blood samples. Viral RNA was extracted on real-time PCR (Abbott 2000®), and sequencing was performed on ABI 3500 (Hitachi®). SPSS version 21.0 software was used for statistical analysis. Of the 128 seropositive volunteer donors included, men and the 29-39-age group were more representative at 78.9% and 49.2%, respectively. Eighty-two samples were sequenced. The majority strains identified were subtype A, subtype F, subtype G, CRF02_AG, and CRF45_cpx. The resistance mutations identified were K103N, L210W, E138G, V179D, V179T, and M46L. The prevalence of resistant subtypes was 25.6%. CRF02_AG strains exhibited high-level resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs), including efavirenz and nevirapine. The study identified major DRMs in reverse transcriptase and protease that confer high-level resistance to most NNRTIs, nucleoside reverse transcriptase inhibitors, and protease inhibitors. CRF02_AG was more predominant, and the frequency of resistant subtypes was high. However, these data will contribute to the therapeutic choice during the initiation of antiretroviral treatment in treatment-naive patients in Gabon.