Background The high endemicity of transfusion-transmissible infections (TTIs) in sub-Saharan Africa is a real public health problem. To reduce the risk of HIV transmission through blood donation, the NBTC of Gabon has launched in recent years a reorganization of its blood transfusion system. This study aims to characterize the molecular strains of HIV-1 circulating in donors and to estimate the risk of viral transmission. Materials and methods A cross-sectional study was carried out during the period from August 2020 to August 2021 among 381 donors who had agreed to donate blood at the National Blood Transfusion Center (NBTC). Viral load was determined by Abbott Real-Time (Abbott m2000®, Abbott) and sequencing by the Sanger method (ABI 3500 Hitachi®). The phylogenetic tree was constructed by MEGA X software. Data were checked, entered, and analyzed using SPSS version 21.0 software, with p ≤ 0.05 considered statistically significant. Results A total of 381 donors were enrolled in the study. Among the 359 seronegative donors, five (5) seronegative donors were detected positive for HIV-1 using Real-Time PCR. The residual risk was 648 per 1,000,000 donations. The prevalence of residual infection was 1.4% [0,01; 0,03]. Sixteen (16) samples were sequenced. The strains obtained were CRF02_AG (50%), subtype A1 (18.8%), subtype G (12.5%), CRF45_cpx (12.5%) and subtype F2 (6.2%). Six sequences clustered with A1, G, CRF02_AG, and CRF45_cpx subtypes. Conclusion The residual risk of HIV-1 transmission by blood transfusion remains a concern in the Gabonese transfusional settings. A policy based on improving the current screening strategy would involve the implementation of the nucleic acid test (NAT) in order to optimize the safety of the donation by detecting the HIV-1 subtypes in circulation in the donors.
Context: The residual risk of HIV transmission is still a real problem into the transfusional settings of limited resources countries. Blood banks of African countries confront the risk of transmitting HIV to recipients. The objective of this study is to estimate the residual risk of HIV in African transfusion settings and to compare this residual risk with that of other countries in the South (developping countries). Methods: This study resulted of a systematic review with meta-analysis of data from several comprehensive studies carried out between 2011 and 2017 whose purpose was focused on the residual risk of HIV transmission through blood transfusion. The studies on the residual risk were systematically searched in the different databases (PubMed, Medline and Google Scholar). The eligibility criteria were based on published studies which had blood donors as participants, looking at the residual risk of HIV in developing countries and the technique was based on the search for antibodies-P24 Antigen of the HIV or on nucleic acid (RNA) testing. Studies carried out before 2011 and after 2017 were excluded. Studies in rich countries were also excluded. The Cochrane tool was used to assess the risk of bias. Results: A total of 327,278 seronegative donors (for 12 eligible studies) were admitted for this study, i.e. 75.5% of men and 24.5% of women. The median age of all donors was 30.4 years. For studies carried out in the Africa zone (Burkina Faso, Ivory Coast, Nigeria, Democratic Republic of Congo, Tanzania and Zimbabwe), 327,278 donors were initially seronegative, of which 626 were found to be positive. Indeed, out of 742 incident cases in this study from African countries and other countries of the South, 84.4% of positive donors came from African studies and 15.6% of positive donors came from other countries of the South in this study. The residual risk (RR) of HIV in Africa has been estimated at 13 per 1,000,000 donations, with an incidence rate (IR) of 21.5 per 100,000 person-years. And in the other countries of the South (Brazil, Croatia, India, Iran, Malaysia and Pakistan), the RR of HIV has been estimated at 0.6 per 1,000,000 donations, or an incidence rate of 1.1 per 100,000 person-years. Conclusion: The residual risk of HIV in the transfusion environment is still high and still persists in blood banks in southern countries in general and in Africa in particular.
Background: Blood transfusions carry the risk of transmitting blood-borne infections. A precise estimate of the transfusion risk of viral infection will help to determine the effect of new and current safety measures in sub-Saharan Africa. This study proposes to estimate the residual risk of HBV in blood banks in African countries and to compare them to other countries in the South. Methods: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. PubMed, Medline, Google Scholar and Zotero were accessed. The eligibility criteria were based on published studies that had blood donors as participants, looking at the residual risk of HBV in developing countries and the technique was based on the search for HBsAg or Hepatitis B Core Antibodies or Nucleic Acid (DNA) testing. The Cochrane tool was used to assess the risk of bias. Results: Twelve articles comprising 71,207 allogeneic and hepatitis B surface antigen (HBsAg)-negative blood donations were included in the meta-analysis. A total of 4912 HBsAg negative African donation including (51.0%) new donors and (49.0%) from regular donors. 80.8% of them were male and the median age was 28 years. Of 1225 HBV strains (47% and 53.4% incident cases) were frequencies in sub-Saharan Africa and in other Southern countries respectively. Considering the twelve participating blood centres as a whole, the incidence rate of new infections was high (4905.1) in sub-Saharan Africa than (869.7) in other Southern countries per 100,000 person-years. In contrast, the estimated residual risk in sub-Saharan Africa (5913 in 1 million donations) was five times higher than estimated in other Southern countries (1048.4 in 1 million donations). Conclusion: Blood donations with HBsAg undetectable by routine testing and low levels of HBV DNA are extremely common in sub-Saharan Africa, at a rate of 5913 per 1 million donations. Given that at least several of these samples could reflect contamination or a false negative result, elimination of infection by a test limited to HBsAg does not prevent transmission.
Background: In resource- limited setting, co-infection between HIV and hepatitis B virus (HBV) poses important public health considerations. This cross-sectional study was undertaken with the aim of determining HBV seroprevalence patterns in urban blood banks. Methods: A cross-sectional study was conducted at an urban blood bank setting. A total of 1610 blood donors were enrolled, and 283 consecutive plasma samples with unknown HBsAg status were selected for risks factors. HBV seroprevalence was based on the Chemiluminescence method (Cobas® e601, Roche). Potential risk factors associated with overt HBV infection were assessed by calculating the crude and adjusted odds ratio, 95% confidence intervalley (95% CI) and p values. Results: Of 1610 participants, overall rate seroprevalence of HBsAg was 5.5% (95% CI: 4.36%–6.58%) ranging from 0.06% (95% CI: 0-0.18) (HCV) to 0.12% (95% CI: 0-0.30) (Syphilis). Seroprevalence of infection increased in older age groups (20-39 years) but men had a statistically significant higher prevalence of overt HBV infection than women (P=0.0001). The multivariate model showed the following to be predictors of HBV infection: male gender (OR=2.5 (95% CI 1.14-5.58), P= 0.02), first-time donor status (OR = 11.06, (95% CI 5.34-22.9), P= 0.01) and residence outside of Libreville (OR = 2.52, 95% CI 1.09-5.83), P=0.03). Conclusion: HB and co-infection are n o t common in Gabon. Intermediate seroprevalence was associated with male gender, first-time donor status and residence outside of Libreville. HCV and HBV infection among the younger age groups are becoming an alarming issue. Prevention and control of HBV infection are needed to reduce HBV transmission.
Background: Blood transfusion carry the risk of transmitting blood-borne infections. HBV genetic diversity and transfusion safety are concepts that are increasingly used in public discourse. However, how the concepts are used and how they are defined remains unclear. The objective of this study is to clarify the concepts emanating from the research project titled «Genetic diversity of HBV and its effect on the transmission risks in blood transfusion in Gabon» and to propose an integrative model of HBV genetic diversity-Transmission risks based on these results. Methods: Three databases were used in the Quantitative analysis: Pubmed, Medline and Google Scholar. The researchers delimited the search to full articles in the databases. The eligibility criteria were based on published studies in English between January 2012 and December 2020, looking at the HBV genetic diversity and the transfusion safety. The Cochrane tool was used to assess the risk of bias. A systematic review was performed on concepts and definitions. Eligible publications were reviewed using concept analysis that led to the extraction of text data for the themes “definition”, “attributes”, “antecedents”, “consequences”, and “related concepts”. The quantitative methods was used to quantify the associations between HBV Genetic diversity and transmission risk examined in the literature. Results: A total of 2685 records were identified by primary and secondary search, of which 802 were retained after examination of titles and abstracts. A total of 144 (18%) publications were included in the review, 123 dealing with Hepatitis B Virus, 38 with Genetic diversity, 94 with Transfusion safety and 94 with Transmission risks were all coded. The final concept coding scheme contained 14 items, each with a satisfactory inter-author reliability score (r) (r ranging from 0.6 and 1), coding Hepatitis B Virus, Genetic diversity, Transfusion safety, Transmission risks, Blood donation-transmission risks, Demographic factors-transmission risks, HBsAg- transmission risks, Anti-HBc-transmission risks, Viral load-transmission risks, measurement errors- transmission risks, viral load-HBsAg, viral load-Anti-HBc, Sequencing-viral load, Genotype- transmission risks. In the resulting integrative model, the elements were mapped to different levels of care. Conclusion: This integrated theory suggests a number of directions to improve the understanding of transfusion safety in the context of HBV genetic diversity, to speak the same language. It provides a basis for creating better measures and interventions in transfusion medicine.
Background: Transmission of HIV through blood transfusion remains a public health problem, particularly in countries in Sub-Saharan Africa. However, no study has determined the epidemiological data regarding HIV-1 infection in Gabonese blood donors. The objective of this study is to assess the seroprevalence of HIV-1 and the risk factors associated with infection in donors from the National Blood Transfusion Center in Libreville (Gabon). Methods: A cross-sectional study carried out from June to August 2020 in 3669 persons donating blood at the National Blood Transfusion Center (NBTC). The ELISA technique (Evolis®, BioRad), the chemiluminescence technique (Cobas® e601, Roche), and the SD Bioline® HIV 1/2 test (Standard Diagnostics. Inc) were used for the detection of anti-HIV-1/2 antibodies and P24 antigen in donor plasma. Data were analyzed using SPSS software version 21.0, with p˂.05 considered statistically significant. Results: The seropositivity rate HIV-1 was 0.8% (30/3669) (95% CI: 0.5; 1.1). The study was composed of 79.4% men and 20.6% women. The most representative age group was of 25-34 years with 54.5%. The seropositivity of men, women, and unrelated voluntary donors was 0.7%, 1.2%, and 1.0%, respectively. The risk factors such as the first blood donation (Adjusted Odds Ratio (AOR) = 0.1 [0.0 ;0.4], P= .002), multiple sexual partners (AOR = 6.2 [2.2;17.2], P= .001), primary educational level (AOR = 10.1 [1.4;75], P = .024), and dental care (AOR = 3.6 [1.2;11], P = .024) were significantly associated with HIV infection. About 0.14% of the patients had co-infection. Conclusion: In the Gabonese context, about one out of a hundred blood donors are HIV-infected. These carriers of HIV infection in the blood banks are mainly new donors with multiple sexual partners, limited education, and poor dental care.
Background: The genetic diversity of human immunodeficiency virus type 1 (HIV-1) is a real problem facing blood banks. This genetic diversity has a negative impact on diagnostic strategies within the transfusion chain by weakening the security of the donation. The objective of this study is to clarify the concepts emanating from the research project entitled : «Genetic diversity of HIV-1 and its effect on the residual risk in blood transfusion in Gabon». Methods: This study was the result of a systematic review and a conceptual analysis of several studies that were systematically searched for in databases (PubMed, Google Scholar, and Medline), and whose object was focused on the genetic diversity of HIV -1 and its impact on transfusion safety. Indeed, the information relating to the concepts coming from the full articles was used. These were obtained by reading the most relevant articles. All relevant studies reporting data on HIV-1 genetic diversity and blood safety published in English between January 2012 and December 2020 have been identified for context. The method of conceptual analysis of « Walker and Avant (2005) » was used to clarify the different concepts of our study. The correlation test was used to show the relationship between the concepts. Results: This systematic review and conceptual analysis study made it possible to determine the variables and to clarify the different concepts (HIV-1, Genetic diversity, Blood transfusion, Residual risk) essential for carrying out our research project entitled: "Genetic diversity of HIV-1 and its effect on the residual risk in blood transfusion". This model made it possible to show the effect of the genetic diversity of HIV-1 on the residual risk in blood transfusion using as model variables : viral load and serological markers (Antibodies and P24 Antigen). Knowledge of molecular strains (URF, CRF, subtypes) during this study made it possible to better identify the molecular strains most involved in the residual risk. Despite its complexity, this conceptual analysis contributed enormously to the understanding of the activities and the quantifiable and non-quantifiable components that participated in our study. Statistical analysis showed that the HIV-1 concept was significantly related to the other three concepts with P = 0.001. Likewise for the concept of genetic diversity was also significantly linked to the two other concepts with P = 0.003. Conclusion: The genetic diversity of HIV-1 in the blood transfusion environment contributes significantly to the transmission of HIV from donor to recipient. The mastery of these molecular strains is essential for the various blood banks to ensure a safe blood supply.
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