Risk factors for hepatitis B and C in multi-transfused patients in Uruguay.

BACKGROUND

In spite of the progress made in the prevention of transfusion-transmitted infections over the last years, these still occur. It was considered that infection by hepatitis B (HBV) and C (HCV) viruses could be a major problem in Uruguay, especially among high-risk individuals, such as multi-transfused patients.

OBJECTIVES

To assess the prevalence of HBV and HCV infection among multi-transfused Uruguayan patients and the impact of serological screening; to evaluate the role of number of transfusions and other potential risk factors for the acquisition of HBV and HCV infection.

STUDY DESIGN

Cross-sectional study of HCV antibodies, HBV surface antigen (HBsAg) and HBV core antibodies (HBcAc) in 409 multi-transfused patients.

RESULTS

Of 409 patients studied, 147 (35.9%) received blood products due to acute bleeding, 118 (28.9%) were hemato-oncological, 75 (18.3%) hemophiliacs, 64 (15.6%) were on hemodialysis and 5 (1.2%) suffered sickle cell anemia. Prevalence of HCV antibody was 12.7%. Of the HCV positive patients, 45 were hemophiliacs, for a prevalence rate of 60.0%. The prevalence rates for hemodialysis and acute bleeding patients were 6.3% and 2.0%, respectively. Prevalence of HBsAg was 1.0%; 16.6% of subjects were positive for HBcAc. The prevalence rates of HBcAc were 48.0%, 15.0% and 3.1% among hemophiliacs, acute bleeding and hemodialysis patients, respectively. There was a direct relationship between the number of products transfused and prevalence of both hepatitis C antibodies and HBcAc. Higher prevalence of HCV and HBcAc was observed among the group of patients who received transfusions before the systematic screening of blood donors.

CONCLUSIONS

Exposure to blood transfusions was the main risk factor for HCV and HBV infection. The systematic serological screening of blood donors was highly effective in reducing transfusion transmitted infections.