NАТ technology – a step forward in hepatitis C screening in Bulgaria

Abstract

Introduction: Globally, blood transfusions are the cause of transmissible infections in between 10% and 15% of all patients. Currently, the testing of donor blood for transmissible infections is utilizing enzyme-linked immunosorbent assay ELISA and chemiluminescence method CLIA for screening and detection of hepatitis C (HCV Ag/Ab). Since February, 2020 all donor samples of blood taken in the 5 centers for transfusion hematology in Bulgaria have been tested for markers of transmissible infections, including HCV, by nucleic acid testing (NAT). Aim: We have set the goal to analyze data produced by the implementation of NAT testing of donor blood for the period of 4 months (from 10th of February to 16th of June, 2020) regarding HCV infected samples. Materials and Methods: We present our experience of using NAT and data produced by its implementation for testing of donor blood for a period of 4 months, from the time NAT technology was implemented in Bulgaria. Results and Discussion: The performance of the multiplex Procleix Ultrio Elite assay as individual donor nucleic acid test for the detection of HCV is evaluated in a retrospective study. An advantage of the method is that it not only allows for timely identification of infected donor blood and saves lives of the recipients but also saves the lives of donors, as treatment of chronic hepatitis C continues to progress and is now effective in clearing the virus in more than half of the patients. In terms of safety and security of diagnosis and blood products obtained, the method has no alternative. Conclusion: A recommendation is drafted: to adopt a strategy to increase the quality of healthcare by introducing a one-time HCV screening for adults aged 18 and above, for individuals at risk and for pregnant women to reduce further the risk of incidental transmission of the hepatitis C virus.