Marion Vermeulen1, Ronel Swanevelder1, Gert Van Zyl2, Nico Lelie3, Edward L Murphy4,5. 1. Operations and Medical Division, The South African National Blood Service, Roodepoort, Gauteng, South Africa. 2. Division of Medical Virology, Stellenbosch University, Stellenbosch, Western Cape, South Africa. 3. Lelie Research, Alkmaar, The Netherlands. 4. Department of Laboratory Medicine and Epidemiology/Biostats, University of California San Francisco, San Francisco, California, USA. 5. Vitalant Research Institute, San Francisco, California, USA.
Abstract
BACKGROUND: The prevalence of hepatitis B surface antigen is estimated to be 6.7% in the South African population and in April 1995 the nation introduced universal hepatitis B virus (HBV) vaccination for newborns and infants. We studied the temporal association of this program with HBV prevalence in young blood donors and the contemporary HBV incidence and residual risk of transfusion-transmitted HBV infection (TT-HBV). METHODS: We used blood donation data from January 2011 to December 2019. Estimation of HBV prevalence donations made by first-time blood donors were analyzed by birth cohort and covariates. To estimate the incidence and residual risk of TT-HBV, mathematical models used data from both first time and repeat donors. RESULTS: HBV prevalence in first-time donors decreased from 0.84% (95% confidence interval [CI] 0.78-0.90) in 2011 to 0.66% (95% CI 0.61-0.70) in 2019. The post-1995 birth cohort had a significantly lower HBV prevalence of 0.14% (95% CI 0.13-0.15) than the pre-1985 birth cohort of 1.29% (95% CI 1.25-1.33) and the odds of HBV infection were reduced in a multivariable model (odds ratio [OR] = 0.28, 95% CI 0.24-0.34). The residual risk of TT-HBV occurring from window-period, occult, and possible vaccine breakthrough infections were estimated at 36.9, 5.8, and 2.2 per million red blood cell transfusions, respectively. CONCLUSION: Donors born after the start of routine HBV immunization had significantly lower prevalence of HBV infection, supporting the effectiveness of the vaccination program. The contemporary residual risk of TT-HBV has decreased and should decline further as more vaccinated young people join the donor pool.
BACKGROUND: The prevalence of hepatitis B surface antigen is estimated to be 6.7% in the South African population and in April 1995 the nation introduced universal hepatitis B virus (HBV) vaccination for newborns and infants. We studied the temporal association of this program with HBV prevalence in young blood donors and the contemporary HBV incidence and residual risk of transfusion-transmitted HBV infection (TT-HBV). METHODS: We used blood donation data from January 2011 to December 2019. Estimation of HBV prevalence donations made by first-time blood donors were analyzed by birth cohort and covariates. To estimate the incidence and residual risk of TT-HBV, mathematical models used data from both first time and repeat donors. RESULTS: HBV prevalence in first-time donors decreased from 0.84% (95% confidence interval [CI] 0.78-0.90) in 2011 to 0.66% (95% CI 0.61-0.70) in 2019. The post-1995 birth cohort had a significantly lower HBV prevalence of 0.14% (95% CI 0.13-0.15) than the pre-1985 birth cohort of 1.29% (95% CI 1.25-1.33) and the odds of HBV infection were reduced in a multivariable model (odds ratio [OR] = 0.28, 95% CI 0.24-0.34). The residual risk of TT-HBV occurring from window-period, occult, and possible vaccine breakthrough infections were estimated at 36.9, 5.8, and 2.2 per million red blood cell transfusions, respectively. CONCLUSION: Donors born after the start of routine HBV immunization had significantly lower prevalence of HBV infection, supporting the effectiveness of the vaccination program. The contemporary residual risk of TT-HBV has decreased and should decline further as more vaccinated young people join the donor pool.
Authors: Marion Vermeulen; Harry van Drimmelen; Charl Coleman; Wendy Sykes; Ravi Reddy; Michael Busch; Steve Kleinman; Nico Lelie Journal: Transfusion Date: 2019-07-02 Impact factor: 3.157
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Authors: Azzedine Assal; Valérie Barlet; Marie Deschaseaux; Isabelle Dupont; Pierre Gallian; Cathy Guitton; P Morel; Harry van Drimmelen; Bernard David; Nico Lelie; Philippe De Micco Journal: Transfusion Date: 2009-02 Impact factor: 3.157
Authors: Nico Lelie; Marion Vermeulen; Harry van Drimmelen; Charl Coleman; Roberta Bruhn; Ravi Reddy; Michael Busch; Steve Kleinman Journal: Vox Sang Date: 2020-01-20 Impact factor: 2.144