Mutimer D J, Olomu A, Skidmore S, Olomu N, Ratcliffe D, Rodgers B, Mutimer H P, Gunson B K, Elias E
Queen Elizabeth Hospital Liver Unit, Birmingham, UK.
QJM. 1994 Jul;87(7):407-11.
Hepatitis virus infection is a major cause of morbidity and mortality in sub-Saharan Africa. The high prevalence of hepatitis B virus (HBV) infection in this region is thought to be due to horizontal transmission during childhood. Hepatitis C virus (HCV) infection is also quite prevalent in Africa, but the epidemiology of this infection has yet to be defined. We examined the prevalence of HBV and HCV serological markers in 220 patients attending sickle-cell anaemia clinics in Benin City, Nigeria, in 228 healthy locals, and in 104 local commercial blood donors, to test the hypothesis that patients requiring blood transfusion from unscreened commercial blood donors (in this area of high prevalence for viral hepatitis) are at great risk for the acquisition of post-transfusion hepatitis. Overall, the frequency of hepatitis viraemia in blood donors was high (14% of donors were either HbsAg or anti-HCV positive). Evidence of previous exposure to HBV was common in all three study groups. Risk of HBV infection for sickle-cell patients was not clearly increased by blood transfusion. HCV exposure, however, appears related to transfusion requirement, and all Western-blot-confirmed anti-HCV-positive sicklers had a history of blood transfusion. Screening of blood products in sub-Saharan Africa is unlikely to reduce prevalence of HBV, but may minimize the risks of HCV transmission.
在撒哈拉以南非洲地区，肝炎病毒感染是发病和死亡的主要原因。该地区乙肝病毒（HBV）感染率高，被认为是由于儿童期的水平传播所致。丙型肝炎病毒（HCV）感染在非洲也相当普遍，但其流行病学情况尚未明确。我们检测了尼日利亚贝宁城镰状细胞贫血诊所的220名患者、228名健康当地人以及104名当地商业献血者的HBV和HCV血清学标志物，以检验这一假设：在这个病毒性肝炎高流行地区，需要从不经筛查的商业献血者那里输血的患者感染输血后肝炎的风险很大。总体而言，献血者中肝炎病毒血症的发生率很高（14%的献血者HBsAg或抗-HCV呈阳性）。在所有三个研究组中，既往接触过HBV的证据都很常见。输血并未明显增加镰状细胞病患者感染HBV的风险。然而，HCV暴露似乎与输血需求有关，所有经免疫印迹法确认抗-HCV阳性的镰状细胞病患者都有输血史。在撒哈拉以南非洲地区筛查血液制品不太可能降低HBV的流行率，但可能会将HCV传播的风险降至最低。
