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      Prevalent hepatitis B surface antigen among first-time blood donors in Gabon

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          Abstract

          Despite chronic Hepatitis B virus (HBV) infection being the main cause of younger-onset complex liver disease including cirrhosis and hepatocellular carcinoma (HCC) in Africa, very little is known regarding the seroprevalence of HBV in the Gabonese general population. This investigation aimed to provide strong epidemiological data and risk factors associated with HBV infection in first-time blood donors representative of the urban adult population. The screening of HBsAg was carried out using 4th generation ELISA kits. The overall seroprevalence of HBsAg was 7.28%. The frequency of HBsAg was differential and marked by annual variations in blood donors from 2009 to 2016. Seroprevalence was 2-fold higher among males versus females (OR = 1.90 (95% CI: 1.75–2.06), P<0.001). HBsAg seroprevalence was significantly higher in donors of the age group 25–35 years old compared to donors of the age group <18 years (OR = 1.64 (95% CI: 1.03–2.60), P = 0.04). The seroprevalence of HBsAg in family/replacement donors (FRD) was significantly higher than that of voluntary non-remunerated donors (VNRD) (OR = 0.88 (95% CI: 0.83–0.94), P <0.001). The simultaneous comparison of HBsAg seroprevalence with blood donation type, gender and age showed that the higher prevalence in FRD was significant only in males between 18 and 45 years and in females between 25 and 34 years of age. This study confirms the high endemicity of HBV in Gabon while identifying the most infected age groups for both men and women.

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          Characteristics, management, and outcomes of patients with hepatocellular carcinoma in Africa: a multicountry observational study from the Africa Liver Cancer Consortium.

          Hepatocellular carcinoma is a leading cause of cancer-related death in Africa, but there is still no comprehensive description of the current status of its epidemiology in Africa. We therefore initiated an African hepatocellular carcinoma consortium aiming to describe the clinical presentation, management, and outcomes of patients with hepatocellular carcinoma in Africa.
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            Prevalence of hepatitis B virus infection among health care workers in a tertiary hospital in Tanzania

            Background Sub-Saharan Africa has a high prevalence of hepatitis B virus (HBV) infections. Health care workers (HCWs) are at high risk of contracting HBV infection through their occupation. Vaccination of HCWs against HBV is standard practice in many countries, but is often not implemented in resource-poor settings. We aimed with this cross-sectional study to determine HBV prevalence, HCW vaccination status, and the risk factors for HCWs contracting HBV infection in Tanzania. Methods We enrolled 600 HCWs from a tertiary Tanzanian hospital. Their demographics, medical histories, HBV vaccination details and risk factors for contracting blood-borne infections were collected using a standardized questionnaire. Serum samples were tested for HBV and hepatitis C virus (HCV) markers by ELISA techniques, PCR and an anti-HBs rapid test. HCWs were divided in two subgroups: those at risk of contracting HBV (rHCW 79.2 %) via exposure to potentially infectious materials, and those considered not at risk of contracting HBV (nrHCW, 20.8 %). Results The overall prevalence of chronic HBV infection (HBsAg+, anti-HBc+, anti-HBs-) was 7.0 % (42/598). Chronic HBV infection was found in 7.4 % of rHCW versus 5.6 % of nrHCW (p-value = 0.484). HCWs susceptible to HBV (HBsAg-, anti-HBc-, anti-HBs-) comprised 31.3 %. HBV immunity achieved either by healed HBV infection (HBsAg-, anti-HBc+, anti-HBs+) or by vaccination (HBsAg-, anti-HBc-, anti-HBs+) comprised 36.5 % and 20.2 %, respectively. 4.8 % of participants had indeterminate results (HBsAg-, anti-HBc+, anti-HBc-IgM-, anti-HBs-). Only 77.1 % of HCWs who received a full vaccination course had an anti-HBs titer >10 ml/U. An anti-HBs point-of-care test was 80.7 % sensitive and 96.9 % specific. There was a significantly higher risk for contracting HBV (anti-HBc+) among those HCW at occupational risk (rHCW) of older age (odds ratios (OR) in rHCW 3.297, p < 0.0001 vs. nrHCW 1.385, p = 0.606) and among those HCW being employed more than 11 years (OR 2.51, p < 0.0001***). HCV prevalence was low (HCV antibodies 1.2 % and HCV-RNA 0.3 %). Conclusions Chronic HBV infection is common among Tanzanian HCWs. One third of HCWs were susceptible to HBV infection, highlighting the need for vaccination. Due to high prevalence of naturally acquired immunity against HBV pre-testing might be a useful tool to identify susceptible individuals.
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              Prevalence and Trends of Transfusion-Transmissible Viral Infections among Blood Donors in South of Iran: An Eleven-Year Retrospective Study

              Background Blood transfusion is considered a potential risk factor for transmission of life-threatening viral infections, including HIV, HCV and HBV infections. This study was performed to find out the prevalence and trends of these infections among blood donors in Southern Iran. Methods The blood donor data recorded in twelve regional blood transfusion centers from 2004 to 2014 were analyzed in an anonymous way with respect to the results of serological screening for HBV, HCV, and HIV infections. Overall, 293454 donors were screened for viral infections. Results Most of the donors were male, married, aged between 20–40 years, educated, and regular donors. The overall seroprevalence rates of HBV, HCV and HIV were 0.15%, 0.1% and 0.004%, respectively. The highest seroprevalence was found for HBV, followed by HCV and HIV. These infections were more prevalent in male, low educated and first time donors. The highest HCV seroprevalence was observed among donors aged 20 to 40 years, while HBV seroprevalence increased with age. The seroprevalence rates of HBV and HCV from 2004 to 2014 showed significant decreasing trends from 0.460% to 0.060% (P < 0.001) and 0.329% to 0.045% (P < 0.001), respectively. Whereas HIV infection had a slight but not significant decline from 0.0173% in 2004 to 0.0028% in 2014 (P = 0.087). Conclusions The decreasing trends of transfusion-transmissible viral infections in blood donations indicate that the attempts of IBTO were successful in improving the safety of the blood supply, since the prevalence rates of viral infections have been reduced to very low levels in blood donations over the years. However, still more effective techniques such as polymerase chain reaction (PCR) are needed to guarantee blood safety.
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                Author and article information

                Contributors
                Role: Data curationRole: Formal analysisRole: Writing – original draft
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: SupervisionRole: Writing – original draft
                Role: MethodologyRole: ResourcesRole: SupervisionRole: Writing – original draft
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Software
                Role: Data curationRole: Formal analysisRole: MethodologyRole: SoftwareRole: Supervision
                Role: ValidationRole: Writing – review & editing
                Role: Data curationRole: Formal analysis
                Role: Formal analysis
                Role: SupervisionRole: Writing – review & editing
                Role: SupervisionRole: Writing – review & editing
                Role: InvestigationRole: Project administrationRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                13 April 2018
                2018
                : 13
                : 4
                : e0194285
                Affiliations
                [1 ] Centre National de Transfusion sanguine, Libreville, Gabon
                [2 ] Laboratoire de Biologie Moléculaire et Cellulaire (LABMC), Université des Sciences et Techniques de Masuku, Franceville, Gabon
                [3 ] Division of Biostatistics, Mayo Clinic, Scottsdale, Arizona, United States of America
                [4 ] Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America
                [5 ] Division of Hematology/Oncology, Mayo Clinic, Scottsdale, Arizona, United States of America
                FDA, UNITED STATES
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0002-6888-6317
                http://orcid.org/0000-0001-7885-8574
                Article
                PONE-D-17-29277
                10.1371/journal.pone.0194285
                5898709
                29652917
                a964b5fb-ba76-439f-a8df-63a01465dc44
                © 2018 Eko Mba et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 7 August 2017
                : 28 February 2018
                Page count
                Figures: 1, Tables: 4, Pages: 10
                Funding
                Funded by: This work was supported by Centre National de Transfusion sanguine through le programme de soutien à la recherche No2 and Agence Universitaire de la Francophonie (AUF). The sponsors had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Award Recipient :
                This work was supported by Centre National de Transfusion Sanguine (CNTS) and Agence Universitaire de la Francophonie (Ref.: G950/442/BACGL 2016/AO/PFD) to CB. The sponsors had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
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                Health Care
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                Microbial pathogens
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