Investigation of HDV in positive HBsAg blood donors using serological and molecular methods

During the blood transfusion the contagious of various infection agents that are mostly viral to the recipients is the most often seen complications. Nowadays, the reliability of blood transfusion depends on escaping from the infected blood donors. Hepatitis markers (HBsAg, anti-HCV) are the most important tests which have to be done to donors. One of the most important problems in HBsAg carriers is the infection risks of HDV.HDV needs HBsAg to cause disease and it causes more severe and progressive liver diseases compare to other hepatotrophic viruses. In the world HDV infection is often an important cause of liver morbidity and mortality. Liver damage in patients with established chronic HDV infection may be caused by HDV infection not by HBV replication.The traditional methods for the diagnosis of HDV infection, such as detection of serum anti-Delta antibodies, are sufficient for the clinical diagnosis of Delta infection. However, such techniques lack the sensitivity and specificity required to characterize the nature of HDV infection more accurately and to assess the efficacy of therapies. Recently, detection of HDV RNA by molecular techniques increased to obtain right diagnosis. Detection of HDV RNA was strongly associated with liver cell damage, even in asymptomatic cases.In this study HDV infection, which is still a serious health problem in our region, is investigated within the HBsAg positive blood donors using serological and moleculer methods.Serum samples of 160 HBsAg positive blood donors, who applied to Blood Bank of University of Dicle, have been investigated in terms of total anti-Delta antibodies using EIA methods. Serum samples of anti-Delta positive cases were then examined for the presence of serum HDV RNA by real time RT-PCR method.Serum HBsAg positivity was found in 3.28% of an increase (160/4882) of in 4882 blood donors who admitted to the Blood Bank of Dicle University between January 2007 and February 2007. Serum anti-Delta antibodies were detected in 8.75% (14/160) of HBsAg positive cases. Moreover, 2 cases, (%14.29, 2/14) that were positive for anti-Delta antibody, had positive serum HDV RNA. HDV RNA positivity rate was 1.25% (2/160) among all HBsAg positive blood donors.It is mandatory to examine the HBsAg positive blood donors for the possible presence of HDV infection. These screening is very important in our region, since HDV infection is still endemic in this part of Turkey. Serum anti-Delta antibodies detected by traditional serological methods are sufficient for a confident diagnosis. The real viremia in these cases can be best shown by using sensitive real time PCR method for the presence of serum HDV RNA.