Hladik W, Kataaha P, Mermin J, Purdy M, Otekat G, Lackritz E, Alter M J, Downing R
CDC-Uganda, Global AIDS Program, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Trop Med Int Health. 2006 Jun;11(6):951-4. doi: 10.1111/j.1365-3156.2006.01643.x.
Screening donated blood for hepatitis C virus (HCV) is important for HCV prevention and is routinely practiced in North America and Europe. However, in many African countries little is known about HCV prevalence or cost-effectiveness of HCV antibody (anti-HCV) screening.
We investigated 2592 plasma specimens collected consecutively from blood donors in central Uganda in 1999. Routine screening by the blood bank included human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg), and syphilis. To assess HCV prevalence and cost-effectiveness of testing, specimens were additionally tested for anti-HCV IgG by enzyme immunosorbent assay (EIA). Specimens repeatedly reactive (RR) on EIA were tested with a recombinant immunoblot assay (RIBA).
Overall, 107 (4.1%) specimens were HCV EIA RR. Fifteen EIA RR specimens (0.6%, 95% confidence interval = 0.3-0.9%) were RIBA positive and 47 (1.8%) were RIBA indeterminate. Most (80%) RIBA-positive specimens were non-reactive for HIV, HBsAg, and syphilis. RIBA positivity was not associated with donor age, sex, number of donations, HIV, or HBsAg positivity. Costs of screening donors for anti-HCV by using EIA were estimated at US Dollars 782 per potential transfusion-associated HCV infection (exposure to RIBA-positive blood) averted.
Current screening tests for other infections are ineffective in removing HCV-positive donations. Testing costs are considerable; cost-effectiveness of identifying HCV-infected donors will be critical in decision making about HCV screening in Uganda.
筛查献血中的丙型肝炎病毒（HCV）对于预防HCV很重要，在北美和欧洲是常规做法。然而，在许多非洲国家，对HCV流行率或HCV抗体（抗-HCV）筛查的成本效益了解甚少。
我们调查了1999年在乌干达中部从献血者那里连续采集的2592份血浆标本。血库的常规筛查包括人类免疫缺陷病毒（HIV）、乙型肝炎表面抗原（HBsAg）和梅毒。为了评估HCV流行率和检测的成本效益，标本还通过酶免疫吸附测定（EIA）检测抗-HCV IgG。EIA反复反应性（RR）的标本用重组免疫印迹法（RIBA）检测。
总体而言，107份（4.1%）标本为HCV EIA RR。15份EIA RR标本（0.6%，95%置信区间=0.3-0.9%）RIBA阳性，47份（1.8%）RIBA不确定。大多数（80%）RIBA阳性标本对HIV、HBsAg和梅毒无反应。RIBA阳性与献血者年龄、性别、献血次数、HIV或HBsAg阳性无关。通过EIA筛查献血者抗-HCV的成本估计为每避免一例潜在的输血相关HCV感染（接触RIBA阳性血液）782美元。
目前对其他感染进行的筛查试验在去除HCV阳性献血方面无效。检测成本相当高；识别HCV感染献血者的成本效益在乌干达关于HCV筛查的决策中将至关重要。
