Estimate of anti-SARS-CoV-2 spike IgG antibodies prevalence among Iranian population based on blood donations: A serial cross-sectional study during the third wave of the pandemic.

OBJECTIVES: Iran is one of the countries that have been confronted with the SARS-CoV-2 epidemic since February 2020. This study aimed to determine the levels of specific IgG antibodies against SARS-CoV-2 among healthy blood donors to estimate the burden of the epidemic. MATERIAL AND METHODS: A serial cross-sectional study was conducted on blood donors who referred to 31 main blood donation centers in different provinces during the third weeks of September, October, and November 2020. A questionnaire was filled out to collect socio-demographic characteristics, history of contact with COVID-19 patients, and history of COVID-19. A blood sample was collected from each participant to assess the antibodies against SARS-CoV-2 using the ELISA method. The crude prevalence of anti-SARS-CoV-2 IgG was calculated. Then it was weighted based on the gender and age groups of the general population in each province and adjusted for test sensitivity and specificity. RESULTS: During three time points of the study, 3840, 3697, and 3152 participants enrolled. The seroprevalence of SARS-CoV-2 IgG antibodies was 19.59% (17.18-22.00), 22.67% (20.70-24.65), and 32.63% (29.93-35.33) over the three rounds of the study. We found an association between the seropositivity and the highest educational level; AOR 0.76 (0.63-0.93), history of close contact with COVID-19 patients; AOR 1.69 (1.35-2.11), and history of confirmed SARS-CoV-2 infection; AOR 8.86 (5.38-14.60). CONCLUSION: This study showed that about one-third of the population had been infected with COVID-19. Furthermore, a significant upward trend in seroprevalence was observed. The predisposing factors indicate the importance of public health.

Hepatitis C (HCV) Viremic Rate and its Correlation to Demographic Factors among HCV Confirmed Iranian Blood Donors.

BACKGROUND: Hepatitis C virus (HCV) viremia is described as persistent HCV RNA among HCV exposed individuals. HCV viremic rate is defined as the proportion of anti-HCV positive and HCV RNA positive individuals to total anti-HCV positive individuals. Knowledge about HCV viremic rate increases understanding HCV epidemiology and provides the likelihood of HCV viremia infection in a given population. The aim of this study was to evaluate HCV viremic rate and demographic parameter correlations among HCV confirmed Iranian blood donors. METHODS: In this analytical, cross-sectional study, serologically confirmed HCV positive blood donors, who were referred to the Iranian blood transfusion centers around the country from November 2015 to September 2017, were included. HCV RNA RT-PCR was carried out by an in-house qualitative assay. Penalized logistic regression was performed for data analysis. STATA software version 13 was used for statistical analysis. RESULTS: Out of 239 subjects, HCV RNA was amplified in 161 (67.36%, 95% CI 61.21% -73.51%). No statistical associations were found between age, gender, education and marriage status with HCV viremic rate. First time donation was found to be associated with HCV viremia status (adjusted odds ratio [AOR]: 3.26; 95% CI 1.07-9.87). CONCLUSION: The results of this study show the likelihood of active HCV infection occurrence among HCV confirmed Iranian blood donors, as the majority are in the active phase of HCV infection. The viremic rate was associated with first time donation. More effective donor selection process and paying special attention to maintenance of non-infected first time donors as a resource of regular donations are needed to improve blood safety. Follow-up studies on viremic first time blood donors are recommended to clarify impact of factors on the occurrence of HCV viremia.

Association of HCV genotype with viral load among Iranian blood donors: a penalized logistic regression.

Background: Hepatitis C virus (HCV) is a blood born virus and the leading cause of advanced hepatitis disease. HCV genotype 3a is predominant among Iranian blood donors. The aim of this study was to evaluate the relationship between HCV genotype and HCV viral load. Methods: In this analytical cross-sectional study 106 anti-HCV positive and HCV RNA positive blood donors referred to Iranian blood centers across the county were entered. HCV viral loads were determined by an in-house one step Taq Man Real-Time RT-PCR assay. Penalized logistic regression was performed for data analysis. STATA software version 13 was used for statistical analysis. Results: The mean age was 37.94 ± 9.04 years ranged from 19 to 58 years. Male gender included 104 (98.1%) of subjects. 31, 10 and 65 subjects were infected with genotypes1a, 1b, and 3a, respectively. The mean viral load was 1.44 × 106 ± 4.5× 105 IU/ml. HCV viral load was not significantly different among subjects infected with HCV genotypes 1, 1.49 × 10 6 ± 4.57 × 10 6 IU/ml compare to genotype 3, 1.40 × 10 6 ± 5.58 4.58 × 106 IU/ml (p=0.93). Conclusion: Although not significant, the frequency of subjects with high viral load (> 800,000 IU/ml) was higher in subjects infected with genotype 3 than those of genotype 1. No associations were found between demographic characteristics and HCV genotype. Although the study was unable to find any association between HCV genotype and HCV viral load/ HCV viral load group, it highlighted the role of high viral load in the high circulation of HCV genotype 3a among Iranian blood donors.

The Usefulness of Anti-HCV Signal to Cut-off Ratio in Predicting Viremia in Anti-HCV in Patients With Hepatitis C Virus Infection.

BACKGROUND: Hepatitis C Virus (HCV) infection is diagnosed by antibody and RNA based methods. Patients with anti-HCV sample rate/cutoff rate (S/CO) ratios > 1 are reported as anti-HCV positive. RNA based methods are introduced to confirm positivity in seropositive samples. OBJECTIVES: The current study aimed to assess relationship between S/CO rates and HCV-RNA levels in the laboratory to identify HCV viremia in patients with a positive anti-HCV. PATIENTS AND METHODS: All serum samples were assayed for anti-HCV by ELISA method. A total of 265 anti-HCV positive patients were tested for HCV-RNA testing by quantitative method using Artus HCV RG Real-time Polymerase Chain Reaction (RT- PCR) kit. Statistical analysis was done by SPSS version 16. RESULTS: Of the 265 patients with HCV infection, 204 (77%) were male and the mean age was 43.53 ± 13.17 years, ranging 1 - 81 years. No correlation was found between S/CO ratios and HCV-RNA levels. There was significant difference in S/CO ratio between viremic and non-viremic subjects. The sensitivity, specificity, negative predictive value, and positive predictive value were 100%, 81.4%, 100%, and 77.2%, respectively in the S/CO ratio of 2.7. CONCLUSIONS: The present study indicated that anti-HCV S/Co ratio is useful to predict non-viremic patients. A cut-off value of 2.7 can determine the usefulness of HCV-RNA testing. Patients with S/CO < 2.7 are not viremic; therefore, HCV-RNA testing is not recommended. It is suggested that laboratories report S/CO ratio along with anti-HCV results to manage HCV infection better, especially in countries that quantitative HCV testing is expensive or not available.

HLA typing of patients with 21-hydroxylase deficiency in Iranian children with congenital adrenal hyperplasia.

Congenital adrenal hyperplasia (CAH) is a group of potentially life-threatening disorders, most often caused by deficiency of steroid 21-hydroxylase. Children with ambiguous genitalia, hermaphroditism, or signs and symptoms of CAH admitted to Children's Medical Center were enrolled in the survey, and 101 patients were found. Karyotyping, clinical examination, and paraclinical tests were done. HLA typing was done in patients with proven classical CAH and their parents. HLA antigens were typed in children with CAH-type 21-hydroxylase deficiency. The antigen frequencies were compared with those of the control population. The studies revealed that two HLA antigens, HLA-B18 and HLA-B21, showed a significant increase in frequency. The calculated relative risk value was high, distinguishing the population of patients and their parents. The relative risk among patients was 11.82 for HLA-B18 and 1.75 for HLA-B21 antigens. There was no relationship between HLA-DR antigens and CAH. Studies on the correlation between HLA and CAH indicate an association with HLA-B18 and HLA-B21 antigens, and they can be used as genetic markers of the disorder in the Iranian population, if they are restricted to Iranian patients.