High Rates of Hepatitis B and C and HIV Infections among Blood Donors in Cameroon: A Proposed Blood Screening Algorithm for Blood Donors in Resource-Limited Settings

Background. Infections with human immunodeficiency virus (HIV), hepatitis B (HBV), and hepatitis C virus (HCV) are currently major public health problems. Methods. A retrospective study was conducted from January to June 2008 at the Blood Bank of the Central Hospital, Yaoundé (Cameroon). The objective was to study the prevalence of HIV, HBV, and HCV and their coinfections among blood donors. Results. A total of 4650 donors were identified, and the sex ratio (male/female) was 14/1. The median age of donors was 28 years (range: 16 to 69 years). Among blood donors, HBV, HIV, and HCV infection prevalences were 12.14%？？ , 4.44%？？ , and 1.44%？？ , respectively. Coinfection with HIV and HBV was observed among 0.77% donors, followed by hepatitis B and C co-infection (0.21%) and HIV and HCV coinfection (0.06%). Co-infection with HIV-HBV-HCV was encountered in 2 donors. The HIV, HBV, and HCV infections lead to a destruction of one out of six sets of blood collected. Conclusion. There is a need to review policies for blood collection from donors, by modifying the algorithm of blood donors testing. Pretesting potential donors using rapid tests could help to avoid collection and destruction of (infected) blood. 1. Introduction Infections due to the human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) are major public health problems worldwide [1]. In sub-Saharan Africa, these infections are frequent among the general population and blood donors [2, 3]. In 2010, 68% of the 34million of people infected with HIV were living in sub-Saharan Africa [4]. Between 1983 and 2001, the Central African region had the highest HCV prevalence worldwide with a prevalence of 6% and this prevalence was 13.8% in Cameroon [5]. The seroprevalence of hepatitis B S antigen among blood donors in Cameroon was 10.7% in 2003 [2]. The HIV, HBV, and HCV coinfections are severe and frequent in sub-Saharan Africa. In a systematic review, the mean prevalence rates of HBV and HCV among HIV-positive people were 15% and 7%, respectively [6]. Indeed, these viruses have the same mode of transmission through sexual intercourse, mother-to-child, and blood transfusion. Furthermore, their coinfection has more negative effects. The influence of HIV on HBV is characterized by a more frequent evolution towards chronicity, an increased viral replication rate, a viral reactivation leading to fibrosing cholestatic hepatitis, and an increased progression towards fibrosis and liver cirrhosis [7–9]. On the other hand, the HBV infection aggravates the progression towards AIDS and an