Temporal trends in hepatitis B and C infection in family blood donors from interior Sindh, Pakistan

BACKGROUND Hepatitis B (HBV) and C (HCV) infections are a serious global and national public health problem. Earlier studies have reported increasing rates of hepatitis infection in Pakistan, particularly in rural areas. Pakistan has no active surveillance program to monitor trends of these infections. The objective of this study was to verify this trend in blood donors from the rural Sindh area of the country. METHODS The study analysed the data of blood donors of interior Sindh who donated blood at JPMC blood bank from January 1, 2004 to September 15, 2007. HBsAg status was determined by using HBsAg Serodia kit and antibodies to HCV using the Detect HCV V.3 Kit. Samples repeatedly reactive for HBsAg or anti-HCV were considered positive for HBV or HCV infection respectively. RESULTS The overall seroprevalence of HBV infection among donors was 6.2 % (95% CI 5.5%-6.9%) and did not change significantly over the study period. Overall seroprevalence of HBV infection in literate blood donors was 5.7 %(95% CI 4.7%-6.8%). Prevalence decreased significantly in this group over the study period (p = 0.05). No other significant trends in seroprevalence of HBV infection were seen in the stratified analyses. The overall seroprevalence of HCV among donors was 7.5% (95% CI 6.8%-8.3%) and increased significantly over the study period from 7.2% (95% CI 5.8%-8.7%) in 2004 to 8.9% (95% CI 7.4%-10.6%) in 2007 (p = 0.02). Significant increase in seroprevalence was particularly seen in literate (p = 0.03), non-first time (p = 0.01) and Sindhi speaking (p = 0.01) donors. CONCLUSION Our study finds a steady increase in the prevalence of HCV infection in blood donors from interior Sindh between 2004 and 2007. On the contrary, decreasing prevalence of HBV was found, particularly in literate blood donors. There may be a need to have rural community-based epidemiological studies to identify the determinants of the spread of HCV infection and also those that are limiting the spread of HBV infection particularly in the literate blood donor population.