Turkish Journal of Hematology Volume: 37 Issue: 1 / 2020

Niazkar HR, et al: First-time Blood Donors in Southwest Iran Turk J Hematol 2020;37:30-35
(0.002%) had confirmed HIV and none of the blood donors were
positive for syphilis. In addition, concomitant infections were
not detected in any donor.
Among the 52,527 first-time blood donors, 231 (0.44%), 116
(0.2%), and 3 (0.005%) donors were positive for HBsAg, HCV,
and HIV, respectively. HBsAg had a higher prevalence than HCV
infection among first-time donors (OR=1.98; 95% CI=1.59-
2.48; p<0.0001).
In the population studied in this investigation, 1.08% (24/2,237)
of CUE-positive and 0.18% (357/196,264) of CUE-negative
donors were positive for disease markers. Table 2 shows a
significantly higher prevalence of HBsAg and HCV in the
CUE-positive than CUE-negative donors (1.08% and 0.18%,
respectively; OR=5.84; 95% CI=3.875-8.820; p<0.0001).
The prevalence of confirmed HBsAg was 1.32% (14/1,060)
and 0.42% (217/51,467) among the first-time CUE-positive
and first-time CUE-negative donors, respectively (OR=3.1;
95% CI=1.814-5.312; p<0.001). The prevalence of confirmed
HCV was 0.85% (9/1,060) and 0.21% (107/51,467) among the
first-time CUE-positive and first-time CUE-negative donors,
respectively (OR=4.05; 95% CI=2.060-7.990; p<0.0001) (Table
3). There were 3 HIV-positive donors among the CUE-negative
first-time donors.
A significantly higher prevalence of HBsAg and HCV infection
was observed in male donors than females among the first-time
donors (p<0.001) (Table 4).
Discussion
Blood and its components are among the most important
causes of TTI transmission. The possibility of TTI transmission
in the transfusion of every blood unit is about 1% [6]. This is
a relatively high rate for transmission of blood-borne diseases
because some of these infections are severe, life-endangering
ones that are incurable or have a difficult treatment process
[6,7]. Thus, TTIs are a significant challenge for blood transfusion
services worldwide and require precise precautions. Different
factors such as vaccination programs, high-risk behaviors, and
the socioeconomic status of people can affect the risk of TTIs
in any community. In recent decades vaccination against HBV
significantly decreased the rate of TTIs in different countries.
In Iran, vaccination against HBV significantly decreased the
rate of HBV infections in comparison with countries without
this program or those with late establishment. The incidence of
HBV, HCV, and HIV is also higher in low-income countries than
in middle- and high-income countries. These data show that
there is a direct correlation between the economic condition of
countries and TTI incidence. Those countries with higher income
Table 1. Distribution of blood donors in confidential unit exclusion -positive and confidential unit exclusion-negative groups.
Group
Total donations,
n (%)
First-time,
n (%)
CUE-positive 2,237 (1.13) 1,060 (2.01)
p
Repeated and regular,
n (%)
1,177 (0.81)
CUE-negative 196,264 (98.87) 51,467 (97.99) 144,797 (99.15)
Total 198,501 (100) 52,527 (100) <0.001 145,974 (100)
CUE: Confidential unit exclusion.
p
<0.001
Table 2. The prevalence of confirmed hepatitis B surface antigen and hepatitis C virus among confidential unit exclusion-positive
and confidential unit exclusion-negative groups.
Group
Study population,
n (%)
HBsAg,
n (%)
p
HCV,
n (%)
p
Total,
n (%)
CUE-positive 2,237 (1.13) 14 (0.63) <0.0001 10 (0.45) <0.0001 24 (1.08) <0.0001
CUE-negative 196,264 (98.87) 233 (0.12) 124 (0.06) 357 (0.18)
Total 198,501 (100) 247 (0.13) 134 (0.07) 381 (0.2)
HCV: Hepatitis C virus, HBsAg: Hepatitis B surface antigen, CUE: Confidential unit exclusion.
p
Table 3. Comparison of hepatitis B surface antigen and hepatitis C virus prevalence among the confidential unit exclusionpositive
and confidential unit exclusion-negative first-time donors.
TTI Group of donations Number of donations Number positive, n (%) p
HBsAg First-time, CUE-positive 1,060 14 (1.32) <0.0001
First-time, CUE-negative 51,467 217 (0.42)
HCV First-time, CUE group 1,060 9 (0.85) <0.0001
First-time, non-CUE group 51,467 107 (0.21)
HCV: Hepatitis C virus, HBsAg: Hepatitis B surface antigen, CUE: Confidential unit exclusion.
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