HIV and Hepatitis B seroprevalence among the nepalese blood donors

Materials and Methods: A total of 66,904 units of blood collected, following donor recruitment criteriaduring March 2009-Sept. 2010 was included for analysis. All donated blood samples were subjected to screening for Transfusion transmitted infections including HIV and Hepatitis B surface antigen using standard ELISA test kits (Dade Behring, Germany). Initial reactive sera were re-tested for reconfi rmation with same test kits plus another test kit (Detect-HIV, Adaltis Inc, and Qualisa).

HIV is characterized a concentrated epidemic in Nepal with HIV prevalence of 0.30% among adult aged 15-49 years in 2011.There are approximately 50,200 people estimated to be living with HIV. 3 HBV is an enveloped DNA virus and a member of the hepadnavirus family. 4It has a double stranded DNA genome of approximately 3200 base pairs organized into four partially overlapping frames, which encodes the envelope, core (precore/core), polymerase and X proteins.The envelope proteins are surface glycoproteins collectively designated as hepatitis B surface antigen (HBsAg).In virus infected liver cells, HBsAg is produced in excess and secreted in blood, where it serves as marker for active infection and infectivity.The presence of detectable HBeAg in serum or plasma is associated with high levels of HBV replication. 5BsAg is the prototype serologic marker of HBV infection and characteristically appears 1 to 10 weeks after an acute exposure to HBV, before the onset of symptoms or elevation of serum alanine aminotransferase (ALT). 6The seroprevalence rate of HBV reported among blood donors was 0.82% nationwide and 0.92% in Kathmandu, over a period of 6 years. 7In Nepal, screening of blood for HBsAg was started from 1979 in Kathmandu and now became mandatory in all blood transfusion centers.Nevertheless, the risk of transfusion cannot be overcome fully due to its window period.
The major objective of this study was to determine the seroprevalence of HIV/HBsAg among the volunteer non-

RESULTS
Out of 66,904 blood samples, 56,973 were collected from male donors and 9931 were collected from female donors.Among the total screened samples, 73 were found to be seropositive for HIV antibody after the repeated array of test.The overall seroprevalence of HIV was found to be 0.10% (73/66,904), of which seroprevalence in male was 0.11% (64/56,973) and 0.09% (9/9,931) in female as shown in table 1. Statistically significant difference was found between male and female donors (χ2<3.841).Table 2 shows that the overall seroprevalence of HIV was highest in age group of 30-39 (p<0.001).Similarly, among the total screened samples, 316 were found to be seropositive for HBsAg.The reactivity was confirmed after the repeated array of test.The overall seroprevalence for HBsAg was found to be 0. 47% (316/66,904) of which seroprevalence in male was 0. 42% (242/56,973) and in female was 0.74% (74/9,931) (Table 1).Statistically significant difference was found between male and female donors in seroprevalence of HBsAg (χ2<3.841).
Here, the overall seroprevalence was highest in age group of 30-39 in male but highest seroprevalence was observed in age group≥50 in female (p<0.001)(Table 3).

DISCUSSION
In the present study, the overall sero-prevalence was found to be 0.

CONCLUSION
The sero-prevalence of HBsAg is an alarming in adult voluntary blood donors; different prevalence in different settings, years & population groups, indicating the need for nationwide representative survey to plan and implement appropriate containment/ control/ prevention strategies.
HIV sero-prevalence is still high in adult voluntary blood donors, indicating the need for expansion of counseling services and quality of testing in BTS for stopping ontowards transmission from the blood donors.

Table 3 : Distribution of HBsAg Sero-prevalence in different age groups
10 addition, the HIV and HBsAg seroprevalence was found to be 0.69% and 4.61% respectively in Thailand, 2002.10Thesedifferencesmightbedue to difference in study population.The high seroprevalence of HBV infection indicates a need for rapid interventions like mass vaccination.Moreover, this study only reflects the scenario of seroprevalence of HIV and HBsAg among blood donors.So, the seroprevalence survey of whole country is essential to plan appropriate interventions inreducing HIV and HBV infections.In addition, the findings of this study showed somehow discordance with the study conducted byKarki et al., 2008seroprevalence of HBsAg-0.92%.This might be due to difference in the samples (sample size, representativeness of the samples in different years).The high seroprevalence is seen in active age group and reason yet to be explored.