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.
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:
- HB core –Total
- HBV –DNA (optional)
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.
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.
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.
Blood Donation: Donor is advised NOT to donate blood until he/she is declared free of HBV infections for 5 years.
Meet the expert: Should you have any clarification please fix up an appointment with the blood bank officer where you donated blood.