Prevalence and screening costs of hepatitis C virus among Ugandan blood donors.
BACKGROUND
Screening donated blood for hepatitis C virus (HCV) is important for HCV prevention and is routinely practiced in North America and Europe. However, in many African countries little is known about HCV prevalence or cost-effectiveness of HCV antibody (anti-HCV) screening.


METHODS
We investigated 2592 plasma specimens collected consecutively from blood donors in central Uganda in 1999. Routine screening by the blood bank included human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg), and syphilis. To assess HCV prevalence and cost-effectiveness of testing, specimens were additionally tested for anti-HCV IgG by enzyme immunosorbent assay (EIA). Specimens repeatedly reactive (RR) on EIA were tested with a recombinant immunoblot assay (RIBA).


RESULTS
Overall, 107 (4.1%) specimens were HCV EIA RR. Fifteen EIA RR specimens (0.6%, 95% confidence interval = 0.3-0.9%) were RIBA positive and 47 (1.8%) were RIBA indeterminate. Most (80%) RIBA-positive specimens were non-reactive for HIV, HBsAg, and syphilis. RIBA positivity was not associated with donor age, sex, number of donations, HIV, or HBsAg positivity. Costs of screening donors for anti-HCV by using EIA were estimated at US Dollars 782 per potential transfusion-associated HCV infection (exposure to RIBA-positive blood) averted.


CONCLUSIONS
Current screening tests for other infections are ineffective in removing HCV-positive donations. Testing costs are considerable; cost-effectiveness of identifying HCV-infected donors will be critical in decision making about HCV screening in Uganda.
Hladik
W
W
CDC-Uganda, Global AIDS Program, Centers for Disease Control and Prevention, Atlanta, GA, USA. wfh3@cdc.gov
Kataaha
P
P
Mermin
J
J
Purdy
M
M
Otekat
G
G
Lackritz
E
E
Alter
M J
MJ
Downing
R
R
D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D001782:Blood Donors; D003362:Cost-Benefit Analysis / Q000379:methods; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006679:HIV Seropositivity / Q000453:epidemiology; D017048:Health Care Costs; D016174:Hepacivirus / Q000302:isolation & purification*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006526:Hepatitis C / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D015151:Immunoblotting / Q000379:methods; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008403:Mass Screening / Q000191:economics*; D015995:Prevalence; D011994:Recombinant Proteins / Q000276:immunology; D014454:Uganda / Q000453:epidemiology
D000914:Antibodies, Viral; D006514:Hepatitis B Surface Antigens; D007074:Immunoglobulin G; D011994:Recombinant Proteins