Risk factors for hepatitis B and C in multi-transfused patients in Uruguay.

BACKGROUND: In spite of the progress made in the prevention of transfusion-transmitted infections over the last years, these still occur. It was considered that infection by hepatitis B (HBV) and C (HCV) viruses could be a major problem in Uruguay, especially among high-risk individuals, such as multi-transfused patients.

OBJECTIVES: To assess the prevalence of HBV and HCV infection among multi-transfused Uruguayan patients and the impact of serological screening; to evaluate the role of number of transfusions and other potential risk factors for the acquisition of HBV and HCV infection.

STUDY DESIGN: Cross-sectional study of HCV antibodies, HBV surface antigen (HBsAg) and HBV core antibodies (HBcAc) in 409 multi-transfused patients.

RESULTS: Of 409 patients studied, 147 (35.9%) received blood products due to acute bleeding, 118 (28.9%) were hemato-oncological, 75 (18.3%) hemophiliacs, 64 (15.6%) were on hemodialysis and 5 (1.2%) suffered sickle cell anemia. Prevalence of HCV antibody was 12.7%. Of the HCV positive patients, 45 were hemophiliacs, for a prevalence rate of 60.0%. The prevalence rates for hemodialysis and acute bleeding patients were 6.3% and 2.0%, respectively. Prevalence of HBsAg was 1.0%; 16.6% of subjects were positive for HBcAc. The prevalence rates of HBcAc were 48.0%, 15.0% and 3.1% among hemophiliacs, acute bleeding and hemodialysis patients, respectively. There was a direct relationship between the number of products transfused and prevalence of both hepatitis C antibodies and HBcAc. Higher prevalence of HCV and HBcAc was observed among the group of patients who received transfusions before the systematic screening of blood donors.

CONCLUSIONS: Exposure to blood transfusions was the main risk factor for HCV and HBV infection. The systematic serological screening of blood donors was highly effective in reducing transfusion transmitted infections.