title: Prevalence of hepatitis B & hepatitis C virus infections in potential blood donors in rural Vietnam.
abstract: OBJECTIVE
  Safe blood and blood products should be offered to all patients in need for blood transfusion. The objectives of the present study were to establish prevalence estimates for hepatitis B and hepatitis C virus infections as a foundation for safe blood transfusion in rural Vietnam, and to check the accuracy of the laboratory analysis used for hepatitis testing of blood donors in Vietnam.
  
  
  METHODS
  A cross-sectional study was conducted in two rural communities in Quang Tri, Vietnam. A total of 1,200 blood samples collected from potential blood donors were tested by an enzyme immunoassay technique (EIA) for detection of hepatitis surface antigen (HBsAg), antibodies to hepatitis B core antigen (anti-HBc), and antibodies to hepatitis C antigen (anti-HCV). The EIA test outcome was validated by a chemiluminescent micro particle immunoassay technique (CMIA).
  
  
  RESULTS
  The prevalence of HBsAg and anti-HBc in the study population was 11.4 per cent (95% CI 9.6 - 13.2) and 51.7 per cent (95% CI 48.8 - 54.5), respectively, the prevalences being higher in males than females. The prevalence of anti-HCV was 0.17 per cent. The test agreement between the EIA and CMIA techniques was high both for HBsAg detection (κ = 0.91; 95% CI: 0.83 - 0.99) and for anti-HBc detection (κ = 0.89; 95% CI 0.81 - 0.97). Compared to CMIA results, the positive and negative predictive values of the EIA tests were found to be 94.9 per cent (95% CI 87.5 - 98.6) and 97.5 per cent (95% CI 86.8 - 99.9) for HBsAg, and 92.4 per cent (95% CI 84.2 - 97.2) and 100 per cent (95% CI 91.2 - 100) for anti-HBc.
  
  
  CONCLUSIONS
  The study shows that hepatitis B virus infection is endemic in rural areas of Vietnam and that almost half of the population is or has been infected. Hepatitis C infection is rare, but false negative test results cannot be ruled out. Also, the results indicate that the EIA performance in blood donor screening in Vietnam may be sub-optimal, missing 2.5 per cent of hepatitis B virus carriers and falsely excluding more than 7 per cent of blood donors. As the prevalence of hepatitis B infection is high, occult hepatitis B infection may represent a threat to safe blood transfusion. Therefore, nucleic acid amplification testing for HBV should be considered for blood donor screening in Vietnam.
authors.affiliation: Tromsoe Mine Victim Resource Centre, University Hospital North Norway, Tromsoe, Norway.
authors.forename: Le
authors.initials: L
authors.lastname: Viet
authors.forename: Nguyen Thi Ngoc
authors.initials: NT
authors.lastname: Lan
authors.forename: Phung Xuan
authors.initials: PX
authors.lastname: Ty
authors.forename: Björn
authors.initials: B
authors.lastname: Björkvoll
authors.forename: Hedda
authors.initials: H
authors.lastname: Hoel
authors.forename: Tore
authors.initials: T
authors.lastname: Gutteberg
authors.forename: Anne
authors.initials: A
authors.lastname: Husebekk
authors.forename: Stig
authors.initials: S
authors.lastname: Larsen
authors.forename: Eystein
authors.initials: E
authors.lastname: Skjerve
authors.forename: Hans
authors.initials: H
authors.lastname: Husum
mesh_terms: D001782:Blood Donors / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D018963:Hepatitis Antigens / Q000097:blood; D006509:Hepatitis B / Q000453:epidemiology*; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D007124:Immunoenzyme Techniques; D008163:Luminescent Measurements / Q000379:methods; D008297:Male; D015995:Prevalence; D012423:Rural Health / Q000706:statistics & numerical data*; D012737:Sex Factors; D014744:Vietnam / Q000453:epidemiology
chemical_list: D018963:Hepatitis Antigens