Abstract
BackgroundLack of confirmatory testing of reactive donations for hepatitis C (HCV), B (HBV) and human immunodeficiency (HIV) viruses hampers reliable residual transmission risk analysis in India.Materials and MethodsIn our centre, 39 295 blood donations were tested for HIV Ag/Ab, anti‐HCV and hepatitis B surface antigen (HBsAg) by a variety of ELISAs and in parallel by individual donation nucleic acid amplification technology (ID‐NAT). NAT yields were confirmed by triplicate repeat reactivity in primary test‐tube and fresh frozen plasma (FFP) samples as well as by viral load (VL) testing and supplemental serologic assays.ResultsNAT and serology concordant reactive results included 23 (0·06%), 290 (0·74%) and 254 (0·65%) donations for HIV, HCV and HBV, respectively. Additionally, 15 HCV (1/2620) and 29 HBV (1/1355) seronegative NAT yield donations were confirmed. HBV marker testing identified three (1/13 100) window period (WP), 25 (1/1637) occult HBV infection (OBI) and one anti‐HBs breakthrough infection. ID‐NAT has reduced residual risk of infection from 1/2600 to 1/270 000 for HCV WP, 1/8000 to 1/21 000 for HBV WP and 1/11 000 to 1/66 000 for OBI.ConclusionA NAT repeat test algorithm was instrumental for confirmation of viral infection and revealed high residual risk of hepatitis B and C transmission by the practiced ELISA blood testing.
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