Prevalence of antibodies to hepatitis C virus and other markers in Jamaica

Three population groups, 1500 blood donors, 513 antenatal women representing a normal population group and 250 sicklers representing a multiply transfused group were studied to determine the prevalence of hepatitis C viral (HCV) infection in Jamaica. The relationship to liver enzyme levels, hepatitis B infection, syphilis and HIV infection was also investigated. Sera were screened by enzyme-linked immunoassay (EIA) for anti-HCV C100-3 and subsequently tested by a supplementary second generation recombinant immunoblot assay (RIBA). In the blood donors, the prevalence of anti-HCV was low, 0.3 per cent - 0.4 per cent, the same level as that reported by several European countries. In the multiply transfused sicklers, the prevalence was more than seven times higher. No HCV infection was detected in the antenatal group. There was little correlation between HCV infection and surrogate markers alanine aminotransferase (ALT) and antibody to hepatitis B core antigen (anti-HBc) and no correlation with sexually transmitted diseases. (AU)

Prevalence of antibodies to hepatitis C virus and other markers in Jamaica

Three population groups, 1500 blood donors, 513 antenatal women representing a normal population group and 250 sicklers representing a multiply transfused group were studied to determine the prevalence of hepatitis C viral (HCV) infection in Jamaica. The relationship to liver enzyme levels, hepatitis B infection, syphilis and HIV infection was also investigated. Sera were screened by enzyme-linked immunoassay (EIA) for anti-HCV C100-3 and subsequently tested by a supplementary second generation recombinant immunoblot assay (RIBA). In the blood donors, the prevalence of anti-HCV was low, 0.3 per cent - 0.4 per cent, the same level as that reported by several European countries. In the multiply transfused sicklers, the prevalence was more than seven times higher. No HCV infection was detected in the antenatal group. There was little correlation between HCV infection and surrogate markers alanine aminotransferase (ALT) and antibody to hepatitis B core antigen (anti-HBc) and no correlation with sexually transmitted diseases.

Prevalence of antibodies to hepatitis C virus and other markers in Jamaica - abstract

Three population groups, 1500 blood donors, 513 antenatal women representing a normal population group and 250 sicklers representing a multiply transfused group, were studied to determine the prevalence of Hepatitis C Viral (HCV) infection in Jamaica. The relationship to liver enzyme levels, hepatitis B infection, syphilis and HIV infection was also investigated. Sera were screened by EIA for anti-HCV C100-3 and subsequently tested by a supplementary second generation recombinant immunoblot assay (RIBA). In the blood donors, the prevalence of anti-HCV was low, 0.3 percent - 0.4 percent, the same level as that reported by several European countries. In the multiply transfused sicklers, the prevalence was more than seven times higher. No HCV infection was detected in the antenatal group. There was little correlation between HCV infection and surrogate markers alanine transferase (ALT) and antibody to hepatitis B core antigen (anti-HBc) and no correlation with sexually transmitted diseases (AU)

A prospective study of transmission by transfusion of HTLV-I and risk factors associated with seroconversion

To evaluate the risk of transfusion-related transmisssion of HTLV-I in Jamaica, a prospective study was initiated, prior to availability of a licensed HTLV-I serological screening assay. This information would prove useful in formulating strategies for blood-donor screening. We followed 118 pre-transfusion HTLV-I-negative transfusion recipients at monthly intervals post-transfusion for 1 year. Laboratory and questionnaire data were obtained at each visit to evaluate the clinical and immunological status of recipients. Cumulative incidence of HTLV-I seroconversion was estimated and risk-factor data associated with seroconversion among 66 HTLV-I-exposed transfusion recipients were analyzed. Seroconversion occurred in 24/54 (44 percent) of recipients of HTLV-I-positive cellular blood components, 0/12 recipients of positive non-cellular donor units and 0/52 recipients of HTLV-I-negative donor units. Significant risk factors associated with recipient seroconversion were receipt of a seropositive cellular blood component stored for less than one week odds ratio (OR) = 6.34, 95 percent confidence interval (CI) = 1.83 to 21.92], male sex (OR = 4.79, 95 percent CI = 1.15 to 20.0) or use of immunosuppressive therapy at time of transfusion (OR = 12.20, 95 percent CI = 0.95 to 156). Risk of blood-borne infection per person per year in Jamaica was estimated to be 0.009 percent. Our results confirm that blood transfusion carries a significant risk of HTLV-I transmission and that screening of donor blood effectively prevents HTLV-I seroconversion. Recipients at greatest risk for seroconversion were those who required multiple transfusions or who were receiving immunosuppressive therapy at the time of transfusion. These patients should be given priority in receiving selectively screened blood components, if universal blood-donor screening for HTLV-I is not possible (AU)

Clinical outcome following transfusion acquired HTLV-1 infection in Jamaica - abstract

To evaluate the acute and long-term risk of adverse clinical outcomes following transfusion acquired HTLV-1 infection, a prospective cohort of recipients were followed-up after transfusion between 1987 and 1988. Pre-transfusion seronegative recipients of HTLV-1 positive blood components were retrospectively identified and subsequently enrolled in the Jamaica Transfusion Study. Recipients were followed at monthly intervals post-tranfusion for one year, then semi-annually. Laboratory questionnaire data and a brief physical examination were obtained at each visit to evaluate the clinical, haematological and immunological status of recipients. Further diagnostic evaluation by dermatology, neurology, haematology and rheumatology were performed when clinically indicated. Sixty-six (66) recipients received Western Blot and/or RIPA confirmed HTLV-1 positive blood components; 24/66 recipients of confirmed positive components sero-converted. Five subjects, 4 sero-converters (SC) and one non-seroconverter (NSC), developed skin rashes 18-39 months post-transfusion [odds ratio (OR) = 8.2, Fishers exact test p = 0.06. One SC developed cleaved atypical lymphocytes on peripheral blood smear 32 months post-transfusion (PT). One SC developed TSP 36 months PT. Two NSC with transient antibody to HTLV-1 PT developed rheumatoid factor negative polyarthritis 20 and 25 months PT. Recipients of HTLV-1 sero-positive blood components appear to be at risk for adverse clinical events. As has been previously reported, TSP can develop after a short incubation period following transfusion findings reinforce the potential public health benefit of HTLV-1 testing of donor blood. However, in countries where health resources are limited, the feasibility of such screening is limited by financial constraints (AU)

Detection of early human T-cell lymphotropic virus type I antibody patterns during seroconversion among transfusion recipients

From a cohort of human T-cell lymphotropic virus type I (HTLV-I) exposed transfusion recipients (N=71) enrolled in the Jamaican Transfusion Study, 11 were selected for detailed laboratory evaluation. All recipients were followed at monthly intervals for 6 months and then bimonthly up to 1 year for evidence of HTLV-I seroconversion. Without regard to results on screening assays, pretransfusion and posttransfusion samples were tested with two licensed HTLV-I whole-virus screening enzyme immunoassays (EIAs), recombinant EIAs for antibody against tax (p40x) and p21e envelope, standard whole virus Western blot (WB), WB enhanced with recombinant p21e, and radioimmunoprecipitation assay (RIPA). In the early period post transfusion, antibody to gag core protein was predominant with anti-p24 generally appearing before anti-p19. Recombinant anti-p21e envelope protein, in EIA and WB format, was frequently the earliest envelope reactively detected, while anti-gp46 in WB and anti-gp61/68 in RIPA system appeared later. Anti-tax antibodies appeared later in the time course of seroconersion. The whole-virus EIAs were less sensitive than the confirmatory assays. The combination of WB and RIPA or WB enhanced with recombinant p21e appeared equally effective in confirming samples as positive by the Public Health Service two gene group confirmatory algorithm. However specificity of this assay approach could not be addressed in this study.(AU)

Report of the blood transfusion service in Dominica 15-17 April 1984

Analyses the situation in relation to the existing blood transfusion service, and the formulation of a national blood programme