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ABO blood groups and their relationship with Australia antigen (HBsAg) and anti-HCV antibody
To find out the relationship of Australia antigen (HBsAg) and anti Hepatitis C antibody (anti-HCV) with ABO blood groups
A prospective observational study
There were a total of 4,026 patients. The prevalence of HBsAg was found to be 2.68% while the prevalence of anti-HCV was found to be 5.61%. Most of the patients belonged to group 'O +ve' while the Australia antigen (HBsAg) was also more prevalent in the blood group 'O +ve' (43.50%). The presence of anti-HCV in the sera was also more prevalent in blood group 'O +ve' (37.60%).
The prevalence of Hepatitis B and C is not uncommon in the patients at Nishtar Hospital
The possible association of blood group antigens with HBV and HCV infection cannot be ruled out.
Knowledge of blood group of patients and their HBsAg and anti-HCV status can minimize the chances of spread of these conditions
The ABO blood group system is the most important blood type system (or blood group system) in human blood transfusion. The ABO blood group system is widely credited to have been discovered by the Austrian scientist Karl Landsteiner, who found three different blood types in 1900; he was awarded the Nobel Prize in Physiology or Medicine in 1930 for his work. Landsteiner described A, B, and O; Alfred von Decastello and Adriano Sturli discovered the fourth type, AB, in 1902.
The Rh blood group system is one of the currently 30 human blood group systems. It is the clinically most important blood group system besides ABO. Individuals either have, or do not have, the "Rh factor" on the surface of their red blood cells. This term strictly refers only to the most immunogenic D antigen of the Rh blood group system. This is usually indicated by Rh positive (does have the D antigen) or Rh negative (does not have the D antigen) suffix to the ABO blood type. However, other antigens of this blood group system are also clinically relevant. These antigens are listed separately (see nomenclature below). In contrast to ABO, immunization against Rh can generally only occur through blood transfusion or placental exposure during pregnancy.
Hepatitis B virus (HBV) and hepatitis C virus (HCV) are of great concern because of their prolonged viraemia and carrier or latent state. They also cause fatal, chronic and life-threatening disorders. HBV and HCV are highly contagious and relatively easy to be transmitted from one infected individual to another by blood transfusion, during birth, by unprotected sex, and by sharing needles.
With the discovery of blood groups by Landsteiner and subsequent great advancement in its study, many workers have tried to find out a possible relationship between the incidence of these blood groups and the incidence of various diseases. Strong association have been described between peptic ulcer and blood group O, gastric carcinoma and blood group A, toxaemia of pregnancy and blood group O, carcinoma cervix and blood group AB, and similar other associations.
In the field of Dermatology and Venereology possible association has also been sought. These include lichen planus and blood group A, pemphigus and seborrhoeic dermatitis and blood group B, vitiligo and blood group AB.
There is no study of blood groups in HBV and HCV infection cases to the best of our knowledge. In this study, we made an attempt to determine any association between blood groups and HBV and HCV infectionS.
This prospective observational study was carried out in Nishtar Hospital, Multan from May 2009 to August 2009. Nishtar Hospital, Multan is a tertiary care hospital with strength of - beds in wards and - beds in the emergency.
All the patients admitted in the medical wards were included in the study.
ABO blood grouping and Rhesus (RH) typing:
ABO and Rh blood groups determinations were carried out on a slide using monoclonal blood grouping antisera; anti-A, anti-B, anti-AB, and anti-D (BIOTEC Laboratories Ltd, Great Britain).
Laboratory tests for HBsAg and HCV antibodies:
Sera were checked for the presence of hepatitis B surface antigen (HBsAg) using ELISA, Hepanostika HBsAg (Murex Biotech Ltd, Dartford, UK). Similarly, IgG antibodies
to HCV were detected using an ELISA technique (Murex anti-HCV version 4.0) according to the manufacturer's
The procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 1983
The names of patients, their initials or their hospital registration numbers have not been used
Data were entered, cleaned and analyzed using SPSS version 16 statistical package.
Differences in prevalence of HBV, HCV for ABO and Rhesus blood group variables were tested for significance using logistic regression.
P value less than 0.05 was considered statistically significant.
Table 1 Distribution of HBV and HCV according to ABO and Rhesus blood groups:
Hepatitis B positive
Hepatitis C positive
Both hepatitis B, C positive
As shown in Table 1, a total of 4,026 patients were screened at Nishtar Hospital, Multan during the study period. Of these, 3,681 (91.43%) were found to be neither HBV positive nor HCV positive. The highest number of subjects belonged to blood group O, 1507 (37.43%) and while an overwhelming 3,472 were found to be Rhesus positive (86.3%). The lowest number of subjects, 173, fell in the AB category.
Table 2 Percentage of Hepatitis B, C according to ABO and Rh blood grouping
Percentage of Hepatitis B positive
Percentage of Hepatitis C positive
Percentage of both Hepatitis B and C positive
It can be seen from Table 2 that of the total Hepatitis B positive subjects, 43.50% belonged to blood group O+ve. Similarly, the highest percentage of HCV positive subjects to had their blood group O+ve. Blood groups A-, AB- and O- had comprised only 0.93% of the total HBV positive subjects each while AB and O- blood groups did not have any subjects who were anti-HCV positive. Both the results were found/were not found to be statistically significant (P<0.05).
The results obtained through this study show that subjects with blood group O are more susceptible to HBV and HCV infections as compared to those with other groups. On the other hand, subjects with blood group AB and also those who are Rh negative show decreased susceptibility to HBV and HCV infections.
These results point to a possible genetic link between inheritance of blood groups and natural defense mechanism against infection. Clark had suggested that the level of natural antibodies in man might be different in various A B O types. It may be assumed that AB genotyped persons have highest degree of natural resistance against HBV and HCV infections whereas O genotyped persons have lesser degree of such natural resistance. Similarly there was significantly lower incidence of HBV and HCV infections in Rh negative individuals. These observations might mean that Rh negative subjects are more resistant to certain pathological conditions despite that hazards encountered in infancy.
From this study it is concluded that inheritance of blood groups and consequent inheritance of certain immunological features may influence the development of HBV and HCV infections. However, larger study involving more number of patients are required to arrive at more definite conclusion.