Cytomegalovirus and Epstein–Barr Virus Seroprevalence among Blood Donors: Implications for a Low-resource Country Contemplating Stem Cell Transplantation

Abstract Background: Cytomegalovirus (CMV) and Epstein–Barr Virus (EBV) infections are a significant cause of morbidity and mortality in haematopoetic stem cell transplantation (HSCT). Co-reactivation of the viruses also plays an important role in the development of acute graft versus host disease. Objective: Serological testing for CMV and EBV was carried out in blood donors to determine the prevalence and epidemiological characteristics of exposed individuals in anticipation of stem cell transplantation. Materials and Methods: EBV viral capsid antigen, Immunoglobulin (Ig) G and IgM and CMV IgG and CMV IgM were assayed in the sera of ninety consecutive family replacement donors by Enzyme-linked immunosorbent assay. Results: The mean age of the participants was 33.3 ± 8.5 years, of which 47/90 (52.2%) were married and 76/90 (84.4%) were males. Fifty (55.6%) and 85 (94.4%) donors were exposed to CMV and EBV, respectively, and exposure to both viruses was 46/90 (51.1%). Seroprevalence for IgG CMV was 33/90 (36.7%) while for IgM CMV it was 17/90 (18.9%). Seven individuals had primary exposure to CMV. Seroprevalence for EBV IgG and IgM was 70/90 (77.8%) and 15/90 (16.7%), respectively. All individuals with IgM EBV also had IgG EBV, showing there was no primary exposure to EBV among the donors. By age 40 years, the donors had been exposed to EBV compared to 50% who had been exposed to CMV. Conclusions: The lower seroprevalence for CMV than expected and the late exposure to EBV would suggest a change in donors socioeconomic status and would impact donor selection for HSCT.