Blackwell Science, LtdOxford, UKTRFTransfusion0041-11322004 American Association of Blood BanksOctober 200444914331440Original ArticleHCV IN THAI BLOOD DONORSTHAIKRUEA ET AL.

BLOOD DONORS AND BLOOD COLLECTION

Risk factors for hepatitis C virus infection among blood donors

in northern Thailand

Lakkana Thaikruea, Satawat Thongsawat, Niwat Maneekarn, Dale Netski, David L. Thomas,
and Kenrad E. Nelson

C
hiang Mai University hospital has the largest
BACKGROUND: The epidemiology, virology, and risk blood bank in northern Thailand. The preva-
factors for hepatitis C virus (HCV) infection among blood lence of hepatitis C virus (HCV) infection
donors in northern Thailand have not been extensively among blood donors has increased from 0.9
evaluated. percent in 1991 to 2.8 percent in 1996.1,2 In contrast, the
STUDY DESIGN AND METHODS: We did a prospective prevalence of HCV among blood donors in the United
matched case-control study of blood donors who tested States is 0.36 percent.3 The main strategy to prevent
positive for HCV and were confirmed by recombinant transfusion-transmitted HCV infection is to screen and
immunoblot assay or nucleic acid testing. Infected donors defer infected donors or those at high risk of infection.4-6
were matched with one to four HCV-uninfected donors for Knowledge of the risk factors associated with HCV infec-
sex, age ± 5 years, and donation at the same site within tion is necessary to develop appropriate prevention and
15 days of the HCV-positive donor. Married donors were control strategies. Several studies conducted in Europe
invited to bring their spouse for HCV testing. and America found that parenteral exposures such as
RESULTS: Among 166 matched sets, a history of blood or blood product transfusion, intravenous drug use
intravenous drug use (IDU), reported by 58 HCV infected (IDU), and contaminated medical injections were signifi-
donors (35.5%) and 2 HCV-negative donors, was strongly cant sources of infection. These countries have imple-
associated with HCV infection (odds ratio [OR], 107.6; mented prevention and control programs to reduce
95% confidence interval, 14.8-780.7). In multivariate infection in targeted populations.7-10 However, no orga-
analysis among donors without a history of IDU, nized HCV prevention program exists in Thailand, in part
significant risk factors included a history of a blood because of lack of information about HCV infection and
transfusion (OR, 28.8), immediate family with a history of
hepatitis/jaundice (OR, 4.4), six or more lifetime sexual
partners (OR, 2.7), and increased frequency of blood ABBREVIATIONS: IDU = intravenous drug use/user; VDRL,
donation (OR, 0.9). Six of 45 spouses of HCV-infected = Venereal Disease Research Laboratory test.
donors, and none of 44 spouses of uninfected donors,
From the Departments of Community Medicine, Internal
were HCV positive (p = 0.005).
Medicine, and Microbiology, Faculty of Medicine; and the
CONCLUSION: Our data indicate that illicit IDU and a
Research Institute for Health Sciences, Chiang Mai University,
history of transfusion are important risk factors for HCV
Chiang Mai, Thailand; the Department of Epidemiology, the
infection in Thailand. Also, our data suggest there may be
Bloomberg School of Public Health; and the Department of
some risk of transmission by sex or other close contact
Medicine, School of Medicine, Johns Hopkins University,
between spouses.
Baltimore, Maryland.
Address reprint requests to: Kenrad E. Nelson, MD, Depart-
ment of Epidemiology, School of Public Health, Johns Hopkins
University, 615 N. Wolfe St, Baltimore, MD, 21205; e-mail:
kenelson@jhsph.edu.
This research was supported in part by grant UA: DA-13202
from the National Institutes of Health and Johns Hopkins
University AITRP grant D43TW0010 (L.R.) from the Fogarty
International Center of the National Institutes of Health.
Received for publication February 27, 2004; revision
received May 7, 2004, and accepted May 10, 2004.
TRANSFUSION 2004;44:1433-1440.

Volume 44, October 2004 TRANSFUSION 1433