Marina Panezai¹ , Abdul Mateen², Kirpa Ram Asghar⁶, Muhammad Mubashar⁷, Inam Ullah⁵ , Rabia Zulfiqar³ , Anam Zahara³ ,Urwa-tul-Isha malik³, Javeria Akseer⁸ , Saima Bibi⁴ , Hanifa Naz⁴  ,Aleeza Kanwal⁴ ,Ayesha Anwar⁴  Sadia Sohail⁴, Nadia Ishtiaq⁴,Fatima Hafeez⁴, ,Dr Imran Ali⁸,Faiza Hameed⁹, Shumaila Umar⁹

1. University of Balochistan
2. Quaid e Azam University Islamabad,Pakistan
3. Government College University,Faisalabad,Pakistan
4. Capital University of Scienece and Technology
5. Bacha khan University Charsadda
6. Virtual University, Sialkot
7. Universiy of Agriculture, Faislabad
8. Sindh Agriculture University, Tandojam,Hyderabad
9. University of Sargodha, Sargodha Main Campus

   Abstract

Although blood transfusion is one of the known therapeutic interventions that cuts across a number of clinical disciplines. It is necessary to test all intending blood donors for HIV infection before donation. The aim of this study was to determine the prevalence of HIV among blood donors at PIMS Blood Bank, Islamabad,Pakistan. A retrospective study was conducted in PIMS Blood Bank through the year 2022. Sera from blood donors were tested for the detection of Anti HIV by using Abott ELISA. Data were abstracted from records and analyzed using Microsoft Excel sheet. From the total of 18500 screened blood samples collected, the prevalence of HIV in blood donors in the blood bank was 0.001% in the 2022 from January to July. The age groups 16-23 and 33-41 were the highest prevalence and the age group 45-54 was the lowest prevalence of HIV infection. The prevalence of HIV among male was higher than in female donors . The trend of HIV infection was decreasing for both male and female blood donors.The prevalence of HIV infections among blood donors is still high in this study setting, and needs constant monitoring to evaluate prevention and control strategies to reduce the burden of transfusion-transmissible HIV infections.

Keywords: Blood donor, HIV, seroprevalence, Pakistan.

Introduction:

HIV has continued to create a great challenge to transfusion medicine,especially in Asia a huge percentage of HIV transmission had been correlated with blood transfusions.1 Since the detection that HIV is transmitted through blood trans- fusion it became necessary to test all intending

Blood donors for HIV infection before they are transfused to ensure the safety of all blood and blood products to the recipients. In past, millions of people were living with HIV accounting for nearly 60% of the global total. In the same year, there were an estimated 1.6 million new HIV   infections and 1.2 million AIDS- related deaths.

In 2013, there were an estimated 793,700 people living with HIV. Therefore, the aim of      this study was to provide information about the trend of HIV sero positivity among the blood donors at PIMS blood bank over the study period and this would allow comparison of the sero positivity over the course of time. The finding could also be used to update intervention programs which focus on the prevention and control of HIV/AIDS.

Methods

A retrospective study was conducted at PIMS Blood Bank during January to July 2019 by reviewing the log book’s data. This was a retrospective study conducted in PIMS Bank Center. The study population was all blood donors who donated blood at PIMS Blood Bank

.The participants were those who weighed not less than 50 kg and were age of greater than or equal to 18 years old. A total of 18500 approximately blood donors’ records were reviewed and included in the study. Serum samples were tested for HIV using fourth Abott Enzyme   Linked   Immunosorbent   Assay    (ELISA) (HIV1/2:). All the tests were done following the manufacturer’s instructions.

  Data on socio-demographic variables, laboratory test    results were collected from registration book of PIMS   Blood Bank using data extraction format. Data were cross- checked for completeness. The data was cleaned, edited and entered into computer and analyzed using Microsoft Excel sheet and the results were present- ed in tables and paragraph.

Ethical approval

Ethical clearance was obtained from Blood Bank administration before the commencement of data collection. Confidentiality of the in- formation was

       ensured as codes instead of the names of the subjects   were registered on the data collection format.

Results

During the 6 month period, 23000 individuals donated blood and screened for HIV infections. From the total donors, (90.1%) and (9.9%) were male and female donors respectively. More men participated in the survey than women, with a male-to-female gender ratio of 4.01. The finding of this study showed that there were 323 HIV positive blood donors. Therefore, the overall prevalence of HIV infection in blood donors was found to be 5.1% in the five consecutive years ( Table1).

Fig.1 Trend of HIV prevalence among blood donors at PIMS Blood Bank from January 2022- June 2022

Table 1: Trend of HIV prevalence among blood donors at PIMS Blood Bank from January 2022 to June 2022

Month               No of Units

screened N % January 1432 75 5.2 February 1538 112 7.3 March 1720 136 7.9 April 1924 89 4.6 May June 2770 64 2.3 Total 9384 476 5.1

                        HIV positive                      

The trend of HIV infection has increased from January to June. Considering age, the age groups 15-24 and 25-34

had the highest contribution and the age group 55-65 the lowest contribution of HIV infection (Table 2 and 3)

Table 2: Infection with HIV among blood donors at PIMS Blood Bank by age groups

Month                                                                  Total

Group	Jan	Feb	March	Apr                                                                                                  il	May	June	%
15-24	33	48	66	25	26	198	41.6
25-34	19	47	46	48	30	190	40
35-44	14	13	14	15	8	64	13.4
45-54	7	2	9	1	–	19	4
55-65	2	2	1	–	–	5	1

Total            75            112                136                         89                 64                476           100

Table 3: Prevalence of HIV among age group at PIMS Blood Bank from January-June 2022.

Age	Total donors	HIV positive	Prevalence
15-24	2938	198	6.75
25-34	4355	190	4.36
35-44	1023	64	6.25
45-54	865	19	2.20
55-65	206	5	2.43
Total	9384	476	5.1

As indicated in table 4 the prevalence of HIV among female blood donors (7.9%) was higher than among male donors . The trend of HIV infection was increasing for both male and female blood donors.

Table 4: Distribution of HIV positive blood donors by gender at PIMS Islamabad

Gender       HIV(+ve)

Monthly donors Male Donors

Total                            Female donors Male N (%)

Female N (%)

January	1432	1194	238	54 (4.5)	21(8.8)
Februar y	1538	1201	337	76(6.3)	36(10.7)
March	1720	1373	347	98(7.1)	38 (11.0)
April	1924	1502	422	61(4.1)	28(6.6)
May June	2770	2244	526	40 (1.8)	24(4.6)
Total	9384	7514	1870	329(4.4)	147 (7.9)

Discussion

age group 15-24 years followed by those who

Blood transfusion is considered as a potential risk factor for the transmission of viruses which are considered to be life-threatening and have a global public health importance such as HIV. In this study, the overall prevalence of HIV infection was 30 (0.001%) . A decreasing trend in HIV seroprevalence among blood donors was reported from Islamabad, Rawalpindi14 Our study reported a higher prevalence of HIV infection compared to previous studies done in Pakistan, Such differences in sero prevalence rate might be due to some differences in risk behaviors, and geographical variation, educational programs, preventive measures, public awareness, condition of the epidemic, donor selection criteria and selection procedure, sensitivity and specificity of screening technologies employed in blood transfusion centers of those countries by performance characteristics of test kits as well as diagnostic algorithms used in each study.

Sex specific prevalence of HIV infection was higher for males than for females. The difference between the two sexes was consistent with other studies that showed a higher prevalence among males. yet the age-specific prevalence was highest among the

were 25-34 years. The higher rate of seroprevalence in these age groups might be at- tributed to their being more sexually active.

Conclusion

The prevalence of HIV infections among blood donors is still high in this study setting, and needs constant monitoring to evaluate prevention and control strategies. To reduce the possible risk of infections, the provision of strict criterion in recruitment of blood donors by promoting the culture of voluntary blood donations, screening of blood and blood products for these pathogens using sensitive laboratory test kits are imperious. Creating community awareness about the mode of transmission and prevention of HIV infection should be strengthened by giving health education. Moreover, conducting further community-based studies to identify societal risk factors exposing communities for blood- borne infections and developing population- specific interventions to interrupt transmission are valuable in recruiting potential volunteer non-remunerated blood donors.

Conflict of interests

We, the authors, declare that there is no competing interest financially or non-financially.

Acknowledgement

We are very grateful for the staff of the blood

bank for their cooperation during the study.

References

1. Fleming AF. HIV and blood transfusion in sub-Saha- ran Africa. Transfus sci.1997; 18(2):167-79.
2. UNAIDS. 2007 AIDS epidemic update. Available at: URL:http://www.unaids.org/en/KnowledgeCentre/HI- VData/EpiUpdate/EpiUpdArchive/2007/default.asp (accessed September 2014)
3. UNAIDs, Global Report 2013 Available at: http://www.unaids.org/en/media/unaids/contentas- sets/documents/epidemiology/2013/gr201   UNAIDS_ Global_Report_2013_en.pdf (accessed September 2014)
4. Central   Statistical   Agency   (Ethiopia)   and   ICF

Interna-   tional.   Ethiopia   Demographic   and   Health semen of men receiving slightly active ART. N Eng J Med, 1998; 339: 1803-1809.

• Kebede D, Aklilu M, Sandere E. The HIV epidemic

and the state of its surveillance in Ethiopia. Ethiop Med J, 2000; 38 (4):283-302.

• Belachew T, G/Sillasie S. Trend of HIV Sero- positiv-

ity among blood donors over 6 yrs (1995-2000) in JUSH blood bank. Ethiop J Health Sci, 2001; 11(2):97-109.

• Kassu A, Moges F, Mekonnen F, et al. Seroprevalence

of human immunodeficiency virus among blood do- nors in Northwest Ethiopia, 1995- 2002. Trop Doct, 2006; 36(2):106-107.

1. Federal Ministry of Health/National HIV/AIDS

 

1. Zachariah R, Harries AD, Nkhoma W, Arendt V, Spielmann MP, Buhendwa L, Chingi C, Mossong J. HIV prevalence and demographic risk factors in blood donors. East Afr Med J. 2002; 79: 88-91
2. Sonwane BR, Birare SD, Kulkarni PV. Prevalence of seroreactivity among blood donors in a rural population. Indian J Med.Sci. 2003; 57: 405-07
3. Tiwari BR, Karki S, Ghimire P, Yadav P, Rajkarnikar

M. Prevalence of HIV in blood donors. J Nepal Health Res Counc. 2008; 6(13):93-7.

1. Birhaneselassie M: Prevalence of Transfusion- Trans- missible Infections in Donors to an Ethiopian Blood Bank between 2009 and 2013 and donation factors that would improve the safety of the blood supply in underde- veloped Countries. Lab Medicine 2016, 47(2):134-139.
2. Mohammed Y, Bekele   A:   Seroprevalence   of

transfu- sion transmitted infection among blood donors at Jijiga blood bank, Eastern Ethiopia: retrospective 4 years study. BMC Res Notes 2016, 9:129.

1. Bisetegen FS, Bekele FB, Ageru TA, Wada FW: Transfusion-Transmissible Infections among Voluntary Blood Donors at Wolaita Sodo University Teaching Re- ferral Hospital, South Ethiopia. Canadian Journal of Infec- tious Diseases and Medical Microbiology Volume 2016.
2. Gelaw B, Mengistu Y: The prevalence of HBV, HCV and malaria parasites among blood donors in Amhara and Tigray regional states. Ethiop J Health Dev 2007, 22(1):3-7.
3. Dessie A, Abera B, Wale F: Seroprevalence of ma- jor blood-borne infections among blood donors at Fele- ge Hiwot referral hospital, Northwest Ethiopia. Ethiop J Health Dev 2007,21(1):68-69.

• Fessehaye N, Naik D, Fessehaye T: Transfusion trans- mitted infections–A retrospective analysis from the Na- tional Blood Transfusion Service in Eritrea. Pan African Medical Journal 2011, 9(1).
• Buseri FI, Muhibi MA, Jeremiah ZA: Sero- epidemi- ology of transfusion-transmissible infectious diseases among blood donors in Osogbo, south-west Nigeria. Blood Transfus 2009, 7(4):293-299.
• National Blood Transfusion Services Strategy

fussion transmissible viral infections among donors at the Red Cross Blood Bank in Gondar University Hospital. Ethiopian Medical Journal 2008, 46(1):7-13.

25. Walana W, Ahiaba S, Hokey P, Vicar EK, Acquah SEK, Der EM, Ziem JB: Sero-prevalence of HIV, HBV and HCV among Blood Donors in the Kintampo Munic- ipal Hospital, Ghana. British Microbiology Research Journal 2014, 4(12):1491-1499.

FDRoE, ministry of Health. Addis Ababa, Ethiopia: 2005.

• Matee M, Magesa P, Lyamuya E: Seroprevalence of human immunodeficiency virus, hepatitis B and C vi- ruses and syphilis infections among blood donors at the Muhimbili National Hospital in Dar Es Salaam, Tanzania BMC Public Health 2006, 6(21).
• Diro E, Alemu S: Blood safety & prevalence of  trans-

• Farshadpour F, Taherkhani R, Tajbakhsh S, Tanges- tani MG, Hajiani G, Sharifi N, Taherkhani S, Nejadbolk- hey A: Prevalence and Trends of transfusion Transmis- sible Viral Infections among Blood Donors in South of Iran: An Eleven-Year Retrospective Study. PLoS ONE 2016, 11(6):e0157615.

Transfusion Transmitted Infections among Blood Do         

• Nada H, Atwa M: Seroprevalence of HBV, HCV, HIV and Syphilis Markers among Blood Donors at Suez Canal University Hospital Blood Bank. J Blood Disorders Transf 2013, 5:177.
  • Al-Gani FA: Prevalence of  HBV, HCV and HIV-1, 2 infections among blood donors in Prince Rashed Ben Al-Hassan Hospital in North Region of Jordan. Int J Biol Med Res 2011, 2:912-916 PubMed 30.Tounkara A, Noumsi TG, Hengel RL. Increasing numbers of HIV infected blood donors reveal an ex- panding HIV-1 epidemic in Bamako, Mali. IntConf Aids. 2004; 15.

31. Central Statistic Authority. Ethiopian Demographic Health Survey (EDHS) 2005, September 2006:21s3-230.