Performance evaluation of a particle agglutination test for antibody to human immunodeficiency virus 1: comparison with enzyme immunoassay.

A performance evaluation of a particle agglutination test (PAT), manufactured by Fujirebio Inc., Japan (Serodia-HIV), for antibody to human immunodeficiency virus type-1 (anti-HIV-1) was carried out and compared with a currently available enzyme immunoassay (EIA), manufactured by Genetic Systems Corp., USA, (HIV-1/HIV-2 EIA). Testing 2,878 Indian donor and patient samples, both tests showed 100% sensitivity and comparable specificity (PAT: 99.8%; EIA: 99.7% among donor samples). We conclude that PAT is a specific and sensitive test for anti-HIV-1; it is simple to perform and does not require sophisticated equipment. Hence it is suitable for mass screening of blood donors in a developing country like India, especially in rural areas where presently no HIV-testing facilities are available.

Detection of HIV-1, HBV and HCV antibodies in blood donors from Surat, western India.

PIP: HIV continues to spread in India mainly through heterosexual intercourse, but also among homosexual men and through blood transfusion. The government of India has mandated since 1992 that donor blood from the larger cities be screened for hepatitis B (HBV) and HIV infections. It is expected that this policy will be extended to other cities. Surat is a town 250 km north of Bombay. Approximately 50% of blood is obtained from professional donors to meet the requirement of blood for transfusion. The authors investigated the extent to which blood from professional and voluntary blood donors was infected with HIV-1, HIV-2, HBV, and hepatitis C virus (HCV). They tested 85 blood samples from professional blood donors and 94 samples from voluntary donors from Surat and Pune, respectively, using ELISA and immunoassay. 56 of the professional blood donors were HIV-1-seropositive, 2 of whom were also seropositive for HIV-2. The voluntary donors were seronegative for both HIV-1 and HIV-2. With regard to infection with HBV, 9 samples from professional donors were reactive for HBsAg, 62 of the total 85 samples were reactive for anti-HBs, and 1 sample was borderline reactive. Among the voluntary donors, 6 were reactive for HBsAg, 3 were borderline reactive for HBsAg, and 5 were reactive for anti-HBs. 47 samples from professional donors were reactive for antibodies to HCV, while 13 samples were indeterminate. 4 voluntary donors were reactive for anti-HCV and 5 were indeterminate. The professional blood donors typically were of lower socioeconomic level, among whom awareness about HIV infection and AIDS is incomplete. The voluntary donors, however, were of relatively higher socioeconomic status, and donated blood to help society or as replacement donors. This latter group was more aware of HIV transmission and AIDS. Many blood banks in India still procure blood from professional donors, most likely the reason why parenterally-transmitted HIV infection still takes place in India.^ieng

Immunization of hospital personnel with low-dose intradermal hepatitis B vaccine.

Hepatitis B (HB) is an occupational hazard among health care workers. The only hope of control is by the use of vaccines. We evaluated the efficacy of HB vaccine, given intradermally to 304 hospital staff members. Two plasma-derived vaccines were used (Merck, Sharpe & Dohme (MSD), USA; Cheil Sugar & Co., South Korea). Both vaccines gave comparable, satisfactory results, the MSD vaccine inducing anti-HBs in 83% of those vaccinated and Cheil Sugar vaccine inducing anti-HBs in 86%. More than 50% developed anti-HBs titres in excess of 1000 mIU ml-1. The vaccines were well tolerated and there were no serious side effects. A good immune response was found when the vaccine was comparatively fresh but there was tapering of response when the vaccine neared the expiry date. The 0.1 ml dose by the intradermal route is safe, cost-effective and suitable for immunization of health care workers in developing countries such as India.

Hepatitis B virus infection in hospital personnel.

BACKGROUND: Healthcare workers are known to be prone to infection with the hepatitis B virus. We did this study, as there are only a few reports from India on the prevalence of this infection among hospital personnel, so that a rational and effective immunization policy could be evolved. METHOD: Eight hundred and sixty-three hospital employees including doctors, nurses, technicians, office workers, orderlies and other ancillary staff were screened by ELISA for both hepatitis B surface antigen and its antibody as indicators of prior infection. RESULTS: Eighty-six (10%) were found to be seropositive for hepatitis B surface antigen alone while in 138 (16%) only the antibody was detected. We did not come across any subject in whom both the antigen and the antibody were present simultaneously. Seropositivity was associated with a history of contact with blood or blood products, accidental parenteral exposure and direct patient contact. A history of close contact with a known patient with hepatitis and a past history of jaundice showed a weaker association, while a history of surgery or dental treatment was not significantly associated with seropositivity. There was a significantly (p < 0.5) higher seropositivity in males than in females. The seropositivity was also related to the employee's socio-economic status. Working in a dialysis unit carried the greatest risk. CONCLUSION: Energetic steps should be taken in all hospitals for the prevention of hepatitis B virus infection among healthcare workers.

Prevalence of hepatitis B surface antigen & its subtypes in high risk group subjects & voluntary blood donors in Bombay.

HBsAg positive subjects belonging to high risk groups and voluntary blood donors were analysed for prevalence of HBsAg among various groups of subjects for ascertaining the carrier status among the voluntary blood donors, HBsAg subtype distribution, and association of HBsAg with blood groups and caste or religion. The prevalence of HBsAg varied from 2.02 per cent in voluntary blood donors to 58.38 per cent in patients of acute viral hepatitis. 70.5 per cent subjects had subtype 'ay' while 23.9 per cent of the subjects had subtype 'ad'. We also found compound 'ady' subtype in 5.6 per cent of our subjects. HBsAg/adr, a subtype not usually prevalent in India, was found in 30 of the 90 'ad' sera. Co-occurrence of HBsAg and anti-HBs was noted in 9 subjects. Homotypic anti-HBs was found to occur together mainly in voluntary blood donors, while heterotypic anti-HBs was found to occur together mainly multi-transfused patients. There was no significant correlation between HBsAg and blood group antigens and a relatively higher incidence of HBsAg among the Jain community was observed.