Antibodies to hepatitis C and other viral markersin multi-transfused patients from Argentina.
BACKGROUND
The knowledge of transfusion-transmitted viral infections in Argentina is scarce. A regional study organized by the Pan American Health Organization let us asses the current status.


OBJECTIVE
To estimate the prevalence of HCV, HBV and HIV infection in a population of multi-transfused Argentinean patients.


METHODS
Multi-center, cross sectional study of 504 patients from national referral institutions in Buenos Aires, who had received more than ten units of blood products in more than two occasions. Demographic and clinical data were collected using a standardized questionnaire. Blood samples were analyzed for a-HCV, a-HIV, HBsAg and a-HBcore.


RESULTS
Patients belonged to five diagnostic categories: onco-hematology (309; 61.3%); hemophilia (96; 19%); acute blood loss (54; 10.7% ); hemoglobinopathies (35; 6.9%); and hemodialysis (5; 1% ); five patients (1%) had two of the previous conditions. Overall prevalence rates of viral markers were: a-HCV 9.3% (CI(95%): 6.7-12.0); a-HBcore 4.8% (CI(95): 2.8-6.7); a-HIV 1.2% (CI(95%): 0.14-2.2) and HBsAg 0.20%(CI(95%): 0.2-0.59). The highest prevalence rates were found among patients living with hemophilia (PLH). There was a significant statistical association (p < 10(-5), OR =78.8 [29.7-209.7]) between a-HCV infection and having been transfused before 1993, when screening blood donors for a-HCV became mandatory in our country. The subpopulation of patients exposed to transfusion before 1993 was conformed mostly by PLH (70.9%) and hemoglobinopathies (18.6%). In this subpopulation, we found a significant association (p < 10(Dot;), OR -40 [5.68-281.66]) between years of exposure to transfusion and a-HCV among the patients under the median age (21.95 years old); however, there was no association for those above the median age (p=0.111).


CONCLUSIONS
a-HCV was found to be the most prevalent infection in the multi-transfused patient population under study. Most infected individuals were PLH, transfused before 1993. This study will provide support for further research aimed at improving blood safety in Argentina.
Remesar
Mirta
M
Servicio de Hemoterapia, Hospital Nacional de Pediatria Prof. Dr. J.P. Garrahan, Combate de los Pozos 1881, (1245) Buenos Aires, Argentina.
Gamba
Cecilia
C
Kuperman
Silvina
S
Marcosa
María Angélica
MA
Miguez
Gabriela
G
Caldarola
Sergio
S
Pérez-Bianco
Raúl
R
Manterola
Alberto
A
Del Pozo
Ana
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001118:Argentina / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D018562:Disease Transmission, Infectious; D005260:Female; D015483:HIV Antibodies / Q000097:blood*; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission; D006467:Hemophilia A; D006509:Hepatitis B / Q000453:epidemiology* / Q000635:transmission; D006510:Hepatitis B Antibodies / Q000097:blood*; D006526:Hepatitis C / Q000453:epidemiology* / Q000635:transmission; D018937:Hepatitis C Antibodies / Q000097:blood*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D065227:Transfusion Reaction
D015415:Biomarkers; D015483:HIV Antibodies; D006510:Hepatitis B Antibodies; D018937:Hepatitis C Antibodies