Hepatitis C Antibodies among Blood Donors, Senegal, 2001

To the Editor: Prevalence of chronic hepatitis C virus (HCV) among blood donors has been assessed in a few West African countries ; most recent estimates range from 1.1% to 6.7% (1–4). A recent meta-analysis of studies, including a confirmation test, yielded an average prevalence of HCV infection of 3.0% (5). Until 2001, no systematic screening of HCV infection occurred among blood donors in Senegal, and blood donation legislation is still pending. We report an assessment of the proportion of blood donors from the Hôpital Principal de Dakar who had HCV antibodies in 2001. Blood donors were all volunteers, recruited independently from the hospitalized patients and registered in a local donors association. We screened for risk factors for bloodborne infections in potential donors through a clinical examination and a confidential questionnaire. Persons with a history of jaundice or a risk behavior were excluded. Serum samples collected from blood donors from June to December 2001 were screened for HCV antibodies by a third-generation enzyme immunoassay (EIA) (HCV Murex 4.0; Abbott Laboratories, Abbott, IL). Confirmation was performed by a recombinant-immunoblot assay (INNO-LIA HCV Ab III update; [Innogenetics, Gent, Belgium]). HCV RNA was detected by a qualitative reverse transcription–polymerase chain reaction (Roche Amplicor HCV test [Hoffman-LaRoche, Basel, Switzerland]). Genotype was determined by the INNO-LiPA HCV II assay (Innogenetics). Presence of hepatitis B surface antigen (HbsAg) and alanine-aminotransferase (ALAT) level are routinely assessed, as well as HIV and human T-lymphotropic virus type l infection. The age of the 1,081 donors ranged from 18 years to 61 years (mean 35.6 years), and 81% were men. First-time donors accounted for 31% and were younger than repeat donors (mean 30.5 years vs. 37.8 years; p < 10 –4). EIA HCV antibodies were found in 18 donors (1.6%). Immunoblot assay was positive for nine, yielding an overall prevalence of 0.8% (exact 95% confidence interval 0.4% to 1.5%). Eight of the nine were repeat donors, but the difference in prevalence compared with first-time donors did not reach statistical significance (1.1% vs. 0.3%). HCV-infected donors tended to be older than unin-fected donors (mean 42.3 years vs. 35.5 years, median 46.7 years vs. 34.6 years, Mann-Whitney test p = 0.04), and the trend with age was significant 1.8%; chi-square trend = 4.39; p = 0.03). ALAT levels of infected study participants were in the normal range (17–55 IU). One participant had an ALAT level above normal. Genotype 2ac has been identified …