Prevalence of HIV and syphilis among Turkish blood donors.

To the Editor: Screening of blood is now mandatory for many diseases and is undertaken routinely in blood banks. Many studies have been done on human immunodeficiency virus (HIV) and syphilis, separately, but knowledge about the interrelationship between these transfusion transmitted diseases is limited.1,2 This study was undertaken to assess the correlation between positivity for HIV infection and syphilis among blood donors of Eskisehir. Donors who applied to our blood center in a 10-year period (1998–2007) were retrospectively evaluated. No professional or honorary donation was included.

Serum samples were screened for anti-HIV by ELISA (microparticle enzyme immunoassay, Axym, Abbott Corp., IL, USA) and for syphilis by the Veneral Disease Research Laboratory (VDRL) test (nontreponemal test, immunotrep Omega Diagnostic, Scotland, UK). Samples were not screened for VDRL. Of the total of 19 630 individuals, 6850 (34%) were females and 12 780 (66%) were males. VDRL positivity was found in 33 donors (0.168%) and anti-HIV was positive in 3 cases (0.015%) (Table 1). When the VDRL test was positive, a confirmatory treponemal test was done. Anti-HIV positivity was also confirmed by the western blot test. For the statistical analyses, chi-square and the Fisher exact test were used.

Table 1

Seropositivity rates in blood donors with VDRL and anti-HIV tests during two 4-year periods.

	1998–2002 (n=10 362)		2003–2007 (n=9268)
	VDRL (+)	Anti-HIV (+)	VDRL (+)	Anti-HIV (+)
Female	1	-	5	-
Male	7	-	20	3
Total	8	-	25	3

The prevalence of VDRL reactivity varied from 0.03% to 0.3% in blood donors in different regions of Turkey.3 VDRL reactivty increased from 0.1% in first period to 0.3% in the second period (P=.001). This seems to be an alarming signal in the local blood banks for the probable increase in syphilis and further diagnostic tests should be applied in these cases. According to the results reported from other regions of Turkey, anti-HIV positivity rates ranged between 0% and 0.66%.4 Anti-HIV positivity was not found in the first period, but in the second period it was 0.03% (P=.105). Two donors with positive HIV serology (66.6%) were also positive for VDRL (P≤.001). The problem of safe blood has become an issue worldwide; there is no available method to reduce the infection risk from transfusion to zero. Thus, it appears to be essential to carefully select appropriate donors and to avoid unnecessary transfusion. In conclusion, blood donors in our region show lower seropositivity rates, although there seems to be a regular increase in the rates of anti-HIV and syphilis. Thus, taking into consideration the rising prevalence of these infections, a routine screening of all the donated blood products for anti-HIV and syphilis should be done, which will assist blood transfusion services in improving transfusion safety.