Trends in Seroprevalence of Hepatitis B, Hepatitis C, HIV, and Syphilis Infections in Iranian Blood Donors from 2003 to 2005

To determine changes (trends) in infection rates of hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and syphilis in Iranian blood donor population. Specimens of 1,004,889 volunteer blood donors in Tehran blood transfusion service from 2003 to 2005 were screened for HBsAg, anti-HCV, anti-HIV1/2, and VDRL (venereal disease research laboratory) reactivity in a cross-sectional survey. Reactive samples were verified using a recognized confirmatory test which consisted of a second independent HBsAg enzyme immunoassay (EIA), and neutralization assay; an additional independent anti-HCV EIA and HCV-RIBA assay; a second independent anti-HIV1/2 test, and HIV Western blot; and a confirmatory fluorescent Treponemal antibody absorbed (FTA-ABS) test, respectively. The seroprevalence of HBsAg, anti-HCV, HIV Ab1/2, and VDRL was 0.9%, 2.1%, 0.2%, and 0.04%, respectively, in all blood donors. Prevalence of confirmed positivity was 0.6%, for HBsAg, 0.1%, for HCV RNA, 0.004%, for HIV western blot and 0.004% for FTA-ABS. Between 2003 to 2005, a decreasing trend was observed in HBsAg frequency. HCV frequency decreased in 2005 compared to 2003. The trend of HIV infection frequency had no increasing or decreasing pattern, and was relatively stable while the trend of syphilis infection frequency increased. Although the frequency of transfusion-transmitted infections is low, it is still far from ideal in the volunteer blood donors. Reduction of trends of infections could be achieved through more scrutiny in donor selection, improved sensitivity of serological tests, and re-evaluation of infection routes in donors.