Retrospective Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 21, 2018; 24(11): 1250-1258
Published online Mar 21, 2018. doi: 10.3748/wjg.v24.i11.1250
Epidemiological features of chronic hepatitis C infection caused by remunerated blood donors: A nearly 27-year period survey
You-Wen Tan, Yan Tao, Long-Gen Liu, Yun Ye, Xin-Bei Zhou, Li Chen, Cong He
You-Wen Tan, Yan Tao, Yun Ye, Xin-Bei Zhou, Li Chen, Cong He, Department of Hepatology, The Third Hospital of Zhenjiang Affiliated Jiangsu University, Zhenjiang 212003, Jiangsu Province, China
Long-Gen Liu, Department of Hepatology, The Third People’s Hospital of Changzhou, Changzhou 213001, Jiangsu Province, China
Author contributions: Tan YW, Tao Y and Liu LG contributed equally to this work; Tan YW designed the research; Tao Y, Ye Y, Zhou XB, Chen L, He C and Liu LG collected and analyzed the data and drafted the manuscript; Tao Y and Ye Y performed the research; Ye Y and He C interpreted the data and revised the statistical analysis; Tan YW and Tao Y wrote and revised the article; all authors have read and approved the final version to be published.
Supported by the Preventive Medicine research projects of Jiangsu Province, No. Y2012016; and the Social Development Project of Zhenjiang City, No. SH2014060. The funders had no role in study design, data collection and analysis, nor decision to publish.
Institutional review board statement: The study was reviewed and approved for publication by our Institutional Reviewer.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: To the best of our knowledge, no conflict of interest exists.
Data sharing statement: The original anonymous dataset is available upon request from the corresponding author at tyw915@sina.com.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: You-Wen Tan, PhD, Attending Doctor, Chief Doctor, Department of Hepatology, The Third Hospital of Zhenjiang Affiliated Jiangsu University No. 300, Daijiamen, Runzhou Distinct, Zhenjiang 212003, Jiangsu Province, China. tyw915@sina.com
Telephone: +86-13914567088 Fax: +86-511-88970796
Received: January 9, 2018
Peer-review started: January 9, 2018
First decision: January 25, 2018
Revised: February 1, 2018
Accepted: February 9, 2018
Article in press: February 9, 2018
Published online: March 21, 2018
Processing time: 66 Days and 1 Hours
ARTICLE HIGHLIGHTS
Research background

The natural history of hepatitis C virus (HCV) is still unclear. One of the main reasons why natural history is not clear is that the time of establishment of the infection is unclear. In this report, the authors followed many patients with HCV who can estimate the time of infection.

Research motivation

In the last century, from the late 1980s to the early 1990s, a large number of paid blood donors emerged in underdeveloped rural areas with a low economic status in Eastern China. Many blood donors were infected with HCV because of the use of contaminated medical devices.

Research objectives

The study aimed to understand the prevalence of HCV infection in blood donors over a nearly 27-year interval and to explore the factors that affect the outcome of HCV infection.

Research methods

A retrospective and cross-sectional study was conducted. The participants, mostly plasma donors, were selected from three administrative villages in the Jiangsu province in Eastern China. A questionnaire was administered among the villagers who had a history of blood donation from the late 1980s to the early 1990s. All participants underwent physical examination, liver B-ultrasonography, and liver stiffness measurement (LSM). In addition, 10 mL of blood was collected from each participant to measure simple liver function parameters [albumin (ALB), alanine aminotransferase (ALT), aspartate aminotransferase (AST)], blood factors [platelet (PLT)], and for hepatitis B surface antigen (HBsAg), antiHCV, and antihuman immunodeficiency virus detection. HCV RNA detection, HCV genotyping, and other tests were carried out in antiHCV-positive patients.

Research results

After a median of 27 years (25-31 years) from the last blood donation to the time of survey, a total of 1694 participants were investigated, and the antiHCV-positive individuals were categorized into three groups: blood donors (n = 12, 3.3%), plasma donors (n = 534, 68.5%), and mixed donors (n = 324, 58.8%). A total of 592 (68.05%) patients had detectable HCV RNA, and 91.9% had genotype 1b. A total of 161 (27.2%, 161/592) patients with chronic hepatitis C (CHC) were considered to have cirrhosis, with an LSM level higher than 12 kPa. Multiple logistic (binary) regression analysis results showed that PLT and IgG levels were associated with cirrhosis.

Research conclusions

The nearly 27-year interval investigation revealed that CHC infection is a very serious public health problem in Eastern China. Plasma donation and subsequent return of blood cells to the donor are the main causes of hepatitis C infection. The main HCV genotype is 1b. Nearly 28% of cases progressed to cirrhosis. Age, especially over 60 years, and regular drinking habits were risk factors associated with cirrhosis.

Research perspectives

This research over 27 years revealed that CHC infection remains a serious public health problem in Eastern China. The epidemiological data in the present investigation may play an important role in focusing on the significance of public health in chronic HCV infection.