Individual donor nucleic acid testing for blood safety against HIV-1 and hepatitis B and C viruses in a tertiary care hospital.
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Date
2012-07
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Abstract
Background. In July 2010, we started universal individual
donor nucleic acid testing (ID-NAT) at our blood bank. This
test simultaneously detects human immunodeficiency virus-1
(HIV-1), hepatitis B virus (HBV) and hepatitis C virus (HCV)
in samples of donor blood. We continued to do the enzymelinked
immunosorbent assay (ELISA) test for these agents, as
per the guidelines of the Drug Controller General of India. We
assessed the impact of ID-NAT in preventing transfusionassociated
transmission of viruses.
Methods. We used fourth generation ELISA to screen
blood samples of all voluntary and replacement blood donors.
ID-NAT was done by transcription-mediated amplification
(TMA).
Results. Of the 18 356 donors, ID-NAT could not be
performed on 2 samples which were inadequate. Of the
18 354 donors tested by both ID-NAT and fourth generation
ELISA, 7 were found to be NAT-positive but ELISA-negative
(NAT yield) for HBV and HCV. The prevalence of NAT yield
cases among routine donors was 1 in 2622 donations tested
(0.038%). Since we supply blood as components (packed red
cells, fresh frozen plasma and platelet concentrate), these 7
units of blood would have yielded 21 components and hence
21 patients could have been infected with HBV and HCV
viruses.
Conclusion. In the vast majority of blood units tested, the
results of ELISA and ID-NAT for HIV-1, HBV and HCV were
concordant. ID-NAT did detect the presence of viruses missed
by ELISA in some blood units. It widespread use in blood
banks would ensure safer blood transfusion.
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CHATTERJEE K, COSHIC P, BORGOHAIN M, PREMCHAND, THAPLIYAL R M, CHAKROBORTY S, SUNDER S. Individual donor nucleic acid testing for blood safety against HIV-1 and hepatitis B and C viruses in a tertiary care hospital. National Medical Journal of India. 2012 Jul-Aug ; 25(4): 207-209.