Hepatitis B antigen - post transfusion studies in Papua New Guinea

To determine the frequency of post transfusion hepatitis (PTH), in Papua New Guinea, 143 patients were serially blood tested after blood transfusion. Detection of HBsAg and anti-HBs was performed either by RIA or a haemagglutination method, and SGOT levels were measured. Of patients transfused with HBsAg positive blood, 85% developed HBsAg or anti-HBs within two weeks of transfusion. 18% developed subclinical PTH; no cases of clinical jaundice were noted. Of patients transfused with HBsAg negative blood, 12% developed HBsAg or anti-HBs within 2 weeks of transfusion. The frequency of PTH was not statistically different from that of the previous group. This study demonstrates that clinical Type B post transfusion hepatitis must be unusual in PNG but mild subclinical post transfusion hepatitis does occur in a minority of patients transfused with HBsAg positive or negative blood. It is postulated that the low frequency of PTH is related to the normally high Hepatitis B immune status of Papua New Guineans. Minimal health benefits would be conferred by the introduction of sensitive and expensive widespread testing for HBsAg in all donor blood; scarce financial resources may be better diverted to other areas of more productive health care.