HIV prevalence in blood donors and recipients in Pakistan: a meta-analysis and analysis of blood-bank data.
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Date
2015-07
Journal Title
Journal ISSN
Volume Title
Publisher
WHO Regional Office for South-East Asia
Abstract
Background: The first instances of HIV-antibody detection in donated blood in
Pakistan were reported in 1988. Since then, documentation of HIV in blood donors
and of rates of transmission via transfusion has been limited. Previously assumed
to have a low prevalence, HIV is an increasing health concern in Pakistan. Since
there is no national, centralized blood-banking system, there are no reliable data
on which to base estimated risks of transfusion-associated HIV infection. This
study was therefore conducted to estimate the prevalence of HIV in blood donors
and recipients in Pakistan between 1988 and 2012.
Methods: Meta-analyses were undertaken of reported prevalences of HIV in
blood donors and recipients published during 1988–2012. Papers were identified
by searching PubMed, Google, CINAHL and PakMediNet and the websites of the
World Health Organization, the national HIV/AIDS Surveillance Project and the
National AIDS Control Programme of Pakistan. In addition, the 1998–2012 records
of the Aga Khan University blood bank were analysed.
Results: The 254 abstracts identified at the preliminary search were reviewed and,
after removal of duplications, case-reports, editorials and reviews, 32 papers were
selected that met the inclusion criteria. All studies that reported on HIV antibodies
in blood donors/recipients were included, irrespective of the methodology used.
Since seroconversion had only been confirmed through supplemental testing in a
few papers, the results were analysed separately for reports based on screening
only and confirmed cases. A total of 142 of 2 023 379 blood donors and 4 of
3632 blood recipients were HIV positive, giving an overall pooled seroprevalence
of 0.00111% in blood donors and 0.00325% in blood recipients. The annual
prevalences of HIV in donors at the Aga Khan University blood banks were similar,
ranging from 0.013% to 0.116%.
Conclusion: Very few reports on HIV in blood donors in Pakistan could be
retrieved, and the overall pooled prevalence is low. However, the limited data and
confounding factors mean that that these results may significantly underestimate
the true situation. It is recommended that a complete survey of blood banks should
be conducted throughout the country, in order to provide a more reliable estimate
of the risk of transfusion-associated HIV infection in Pakistan.
Description
Keywords
blood bank, blood donors, blood transfusion, HIV, Pakistan, transfusion-transmitted infection
Citation
WHO South-East Asia Journal of Public Health 2015;4(2): 176-183.