The Prevalence of Transfusion-Transmitted Infections and Nucleic Acid Testing Among Blood Donors in Makkah, Saudi Arabia.

Background: Despite saving a vast number of lives through blood transfusions, transfusion-transmitted infections (TTIs) still threaten the lives of people needing blood transfusion. Hence, screening blood donors and reviewing the prevalence of TTIs amongst blood donors might show the impact of these infections among our people. The aim of this study was to evaluate the prevalence rates of transfusion-transmitted infections among blood donors in Makkah as foundation for providing harmless blood transfusion in Makkah, Saudi Arabia.

Methods: A retrospective study was carried out at the Central Blood Bank in Makkah city, Saudi Arabia, from January 1, 2023, to December 31, 2023. A total of 13,706 samples were collected and screened for hepatitis B surface antigen (HBsAg), hepatitis B surface antibodies (HBsAbs), hepatitis B core antibodies (HBcAbs), antibodies to hepatitis C virus (anti-HCV), antibodies to HIV 1 and 2 (HIV I/II Ab), antibodies to HTLV 1 and 2 (HTLV I/II Ab), Malarial antibodies, and antibodies to VDRL.

Results: A total of 13,706 blood units were received and tested. Out of the total, 52% were non-Saudi donors and 47.9% were Saudi donors; 28.4% were aged 18 - 28 years, 42.8% were aged 29 - 39 years, 24.4% were aged 40 - 50 years, and 4.4% were aged 51 - 60 years. The majority was O+ blood group (42.7%), followed by A+ (26.2%), B+ (18.7%), AB+ (4.6%), O- (3.8%), A- (2.1%), B- (1.5%), and AB- (0.4%). While 42.6% of the blood units donated were from voluntary donors, 57.4% were donated by replacement donors. Sixty-one samples (0.4%) tested positive for HBsAg, 824 samples (6%) for HBcAb, 43 samples (0.3%) for HCV antibodies, 754 samples (5.5%) for HBsAb, and 44 samples (0.3%) for HIV I/II Ag/Ab combinations. Further, 44 samples (0.3%) were positive for HTLV I/II antibodies, 83 samples (0.6%) for VDRL antibodies, and only 3 samples (nearly 0%) for malaria antibodies. Forty-three samples (0.3%) were positive for NAT-HBV, 7 samples (0.1%) were positive for NAT-HCV, and 6 samples (0.1%) were positive for NAT-HIV. The analysis revealed a statistically significant and strong correlation between HBsAgs and NAT-HBV (r = 0.819, p < 0.0001). In contrast, while there was a statistically significant association between HBsAgs and HBcAbs, the correlation was weak (r = 0.191, p < 0.0001). Additionally, there was an association between HBsAbs and HBsAgs, but the Spearman correlation indicated a very weak relationship (r = 0.042, p < 0.0001).

Conclusions: Prevalence rates of transfusion-transmitted infections showed a steady decline in 2023, and these rates were much lower in Makkah than in other parts of the country or in neighboring countries. The importance of using NAT in the screening of blood donors was indicated in this study. These findings could contribute to improving the understanding of TTIs epidemiology and supporting health authorities in controlling blood-borne pathologies.