1. Prevalence of HIV infection among blood donors at the National Blood Transfusion Centre in Bangui, Central African Republic
Claudine Bekondi1a, Pulchérie Pelembi1b, Aubin Béré1c, Richard Gondia2, Mirdad Kazanji1d*
1 Institut Pasteur de Bangui, BP 923 Bangui, République Centrafricaine : a Laboratoire des Virus Oncogènes, b Service de Rétrovirologie - VIH, cLaboratoire d’Analyses Médicales, d Unité de Rétrovirologie et Virus Oncogènes, 2 Centre National de Transfusion Sanguine de Bangui, République Centrafricaine, * Present address: Institut Pasteur de la Guyane, Guyane Française
BACKGROUND
Although human immunodeficiency virus (HIV) is mainly sexually transmitted in the world, HIV infection resulting from blood transfusion is still possible during immunological window period even each unit of blood is tested for anti-HIV 1 and 2 antibodies.
In high-income countries, the use of 4th generation tests and the nucleic acid amplification technology had been well instituted so that the risk of transmission of HIV through transfusion of contaminated blood is extremely low.
By contrast, blood safety remains a major public health problem in low-income countries, particularly in sub-Saharan Africa where the transfusion of infected blood is the cause of 5-10% of HIV infections (WHO, 2013).
The Central African Republic (CAR) is strongly affected by the HIV epidemic and the HIV prevalence rate in adults (15-49 years old) was estimated to be about 4.6% in the general population (UNAIDS, Global Report 2012).
Because of lack of financial resources, the National Blood Transfusion Centre (NBTC): the unique blood bank in Bangui has opted for the use of one rapid antibody test for the HIV screening of blood donation.
Because the window period remains a significant interval, this situation suggests that some HIV infected blood units may continue to pass through screening undetected.
OBJECTIVE
To determine the true prevalence of HIV infection among blood donors at the NBTC of Bangui (CAR )
MATERIAL ET METHODS (2)
Flowchart of HIV screening performed at the Pasteur Institute of Bangui
MATERIAL AND METHODS (1)
Flowchart of HIV screening performed at the NBTC of Bangui
Blood donors: 2546 voluntary and apparently healthy adults (2355 men and 191 women; mean age: 26 [18-58 years]) included in the study between February 2012 and February 2013; written informed consent obtained from each blood donors and a pre-test counselling done by qualified staff.
RESULTS (2)
Distribution of HIV infected blood donors according to the age group and sex
The prevalence of HIV infection is higher in the age groups < 41 years.
By contrast, sex is not related to HIV infection.
Prevalence of HIV infection among blood donors = 4.6%
The use of 4th generation tests contributed to detected 26 samples declared false negative by the NBTC of Bangui
RESULTS (1)
Flowchart of HIV Screening at the CNTS Vs IPB
CONCLUSION
The high prevalence of HIV infection among blood donors (4.6%) is similar to the prevalence reported in the general population.
The HIV screening of blood donations performed at the National Blood Transfusion Centre of Bangui by one rapid antibody test is insufficient.
The use of the 4th generation tests improved the HIV screening of blood donations probably collected during the immunological window period
Public health authorities should increase efforts to reinforce the blood safety at the NBTC, the unique blood bank in Bangui, CAR