A blood donor came up with the question as to what he/she should do if he/she gets to know that he/she has been tested positive for any disease?
A donor may test positive for HIV, Hepatitis –B, Hepatitis-C, Syphils or Malaria. Here, Dr Shivram C, Consultant & Chief Manipal Hospital Transfusion Services answers the question from a perspective of a donor who tests reactive (positive) for Hepatitis B infection (HBsAg-Reactive).
What is Hepatitis B?
Hepatitis B is an infectious illness caused by hepatitis B virus (HBV) which infects the liver of hominoidea, including humans, and causes an inflammation called hepatitis. Hepatitis B is primarily acquired through the parenteral route (unsterile injections /tattoing/ ear-piercing/sharing of razors etc) and less often by the sexual route. Majority of donors testing reactive do not re-call any source of infection. Hepatitis B surface antigen positive/ reactive need not always mean that you have the infection currently. Costly tests are required to confirm the diagnosis. These are not done in a blood bank, but need to be done in any good laboratory.
Advice to Donors:
In the forthcoming issues, expert doctors will answer queries on the steps need to be taken by donors for HIV, Syphilis or Malaria.
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Tests: The donor is advised to get the a few tests done and see a gastro-enterlogist whether the symptoms are present or not.
A battery of blood tests (No fasting necessary) are needed to establish the diagnosis and get some baseline information on the donor’s liver function. It is important to prevent/ treat HBV infection because the long term risk of Hep B virus is cancer of the live.
Generally, the following tests are done from an investigative perspective:
- HBeAg
- HB core –Total
- Anti-HbeAg
- LFT
- HBV –DNA (optional)
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Vaccination: Active and Passive- For family only not for the affected donor.Treatment of Hepatitis B is costly and hence the emphasis is on vaccination and prevention of spread to family members who form close contacts of the affected person.
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For the spouse
Accelerated Vaccination is advised for the spouse in 0. 1, 2 ,months and then after 1 year. This is to be backed up by a Booster dose every 5 years. Anti-HbsAg titres should be checked after three months and annually there after. Hepatitis B Vaccine from any manufacturer should do. Dose of Vaccine is 12 IU/Kg body weight. For an adult weighing 70 Kg , 70 X 12= 840 IU or 4 vials of the drug are needed. Paediatric Vials (0.5ml=100 IU) are also available. A means of passive protection is the usage of Hepatitis B Immunoglobulins till vaccines take effect. Alternative to Immunoglobulins : Complete abstinence from sex in all forms (oral/vaginal etc). A Less effective alternative is the Use of condoms for 3 Months till Anti-HbsAg titres are adequate. -
Other Family Members Normal Vaccination for others in the family in 0, 1, 6 months. Anti-HBsAg titres should be checked booster doses should be given after every 5 years.
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Self Treatment: Not everyone who tests HBsAg positive needs treatment. Only if the virus persists in the body for more than 6 months ( Chronic Hepatitis B infection) then treatment may be needed in the presence of active disease It is detected by HBV DNA positivity and rising viral levels. To know whether you need treatment please see a gastroenterologist.
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Blood Donation: Donor is advised NOT to donate blood until he/she is declared free of HBV infections for 5 years.
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Meet the expert: Should you have any clarification please fix up an appointment with the blood bank officer where you donated blood.