The majority of those who did not participate had temporarily out-migrated, and only 6.1% of villagers who were contacted refused to participate. (OR, 8.3 [95% CI, 2.1C32.0]). Plasma donors had a higher risk of being HCV ID1 seropositive than did whole-blood donors (OR, 7.6 [95% CI, 2.9C20.9]), and female donors had a lower risk than did male donors (OR, 0.32 WY-135 [95% CI, 0.12C0.80]). The strength of the association between selling blood and HCV seropositivity was weaker when plasma donors were excluded (OR, 8.0 vs. 14.4). Conclusions Unsafe practices during illegal plasma donation led to a high risk of HCV seropositivity for donors during the 1980s and 1990s. Failure to screen for HCV increased the risk of seropositivity for WY-135 transfusion recipients during this same period. China has taken steps to halt illegal plasma collection and to improve blood-banking methods. However, there will be an ongoing challenge to care for patients with HCV infection, even as its incidence decreases. The global hepatitis C virus (HCV) seroprevalence rate varies widely, from 1% in Hong Kong and Sweden to 114% in Egypt and Cameroon . An estimated 3.2% of persons in mainland China are infected with HCV . Percutaneous exposuresincluding reuse of needles and syringes, injection drug use, and transfusion of unscreened blood productsare well-established risk factors. Two Chinese studies published in 2004 showed that 70% of injection drug users (IDUs) in Sichuan and Guangxi Provinces were seropositive for HCV antibodies [3, 4], compared with 60% of IDUs in the United States . In most industrialized countries, the risk of acquiring HCV infection through blood transfusion is now significantly reduced, because transfused blood is screened and risk behaviors in donors are identified. However, in resource-limited developing countries, transmission of HCV by blood transfusion and the medical reuse of needles and syringes remain serious public-health problems [6, 7]. The first major HCV outbreak documented in China was reported in 1985 in plasma donors . During the late 1980s and early 1990s, illegal commercial plasma-collection centers were common in selected rural areas of central China. At these centers, pooling blood and then reinfusing red blood cells of the compatible blood type into donors was performed, so that donors would not become anemic WY-135 and therefore could donate more frequently. Several bloodborne diseases, including HCV and HIV infection, were thus transmitted efficiently. A high HCV seroprevalence rate was observed in plasma donors in Hebei, Shandong, Hunan, Hubei, Henan, and even in WY-135 Beijing [8C12]. In the late 1990s, illegal plasma-collection practices were reduced markedly as a result of government legal action. We conducted a community-based epidemiological study to evaluate the HCV seroprevalence rate in residents of communities where illegal plasma-collection practices have been documented and to explore the risk factors associated with HCV seropositivity. Subjects, Materials, and Methods Study context This epidemiological survey was conducted for planning purposes as part of a larger, ongoing projectthe China Integrated Programs for Research on AIDSled by the Chinese Center for Disease Control and Prevention. Our study estimated HCV seroprevalence rates and risk factors for HCV seropositivity in residents of communities in Shanxi Province in which illegal commercial plasma-collection centers had been present. The study protocol was approved by the Division of AIDS Prevention Science Review Committee of the National Institute of Allergy and Infectious Diseases and the institutional review boards of the Chinese National Center for AIDS/STD Prevention and Control and the University of WY-135 Alabama, Birmingham. Written, informed consent was obtained from all subjects. The human-experimentation guidelines of the US Department of Health and Human Services and the National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, were followed in the conduct of the research. Study site and subjects Shanxi Province is located in central China and, to the south, borders Henan Province, which had the most severe HIV epidemic caused by unhygienic practices during plasma collection. Of the 644 HIV infections reported during 1995C2003, 76% were associated with plasma/blood collection . A township in the southern part of Shanxi Province was selected as the study site because an illegal commercial plasma-collection center had operated there in approximately 1995 and because local health officials had reported that many HIV-infected persons lived there. Twelve of 25 villages in the township were selected on the basis of their history of having.
The majority of those who did not participate had temporarily out-migrated, and only 6
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