Abstract
Background: Safe blood transfusion to the people is essential requirement of health care delivery system. Despite the mandatory screening of blood with newest, very sensitive serological test, considerable risk remains for transfusion transmission of virus due to window period infections. Study was aimed to analyze the efficacy of Mini pool Nucleic Acid Amplification Testing as additional donor screening program and its role in improving blood safety in the high prevalence population. Material and Methods: Study was performed at a tertiary-care, accreditated hospital from June 2013 to December 2015 All negative cases for anti-HIV, anti-HCV and HBsAg by ELISA were subjected to MP-NAT to detect HIV-1, HIV-2 and HCV-RNA with HBV DNA.Results: In 31 months, 20470 donations were received of which whole blood donations were 16997 (83.03%) and 3473 (16.97%) apheresis. Out of 16997 donations, 446 (2.61%) were seroreactive. Out of 16551 sero-negative donors subjected to MP-NAT testing, 17 (0.10%) were NAT reactive (NAT yield -1 in 974). Out of 17 cases, 12 were HBV (1 in 1379), four HCV (1 in 4138) and one HIV NAT reactive (1 in 16551). Conclusion: NAT has improvised the blood safety by detecting the virus in the pre-seroconversion, window period thereby providing much higher sensitivity as compared to newest generation serological tests. In countries with high incidence of infection with significant number of window period donations, NAT can serve as a valuable tool along with other serological testing in high prevalence, resource constrained countries to achieve the goal of zero risk of blood.
Highlights
IntroductionNucleic acid testing in window period donation
Safe blood transfusion to the people is essential requirement of health care delivery system which can be doneCorrespondence: According to Joint United Nations Programme on HIV /Nucleic acid testing in window period donationAIDS (UNAIDS) global report 2015, 36.9 million (34.3 million - 41.4 million) people globally are living with Human Immunodeficiency Virus(HIV) while in Asia and pacific 5 million (4.5 million-5.6 million) people are living with HIV.[5]
The primary objective of this study is to analyze the efficacy of MP-Nucleic Acid Testing (NAT) testing as additional donor screening programme, seroprevalence of transfusion transmitted infections (TTI) and its role in improving blood safety in the high prevalence population coming to a tertiary care, super- specialty hospital
Summary
Nucleic acid testing in window period donation. AIDS (UNAIDS) global report 2015, 36.9 million (34.3 million - 41.4 million) people globally are living with Human Immunodeficiency Virus(HIV) while in Asia and pacific 5 million (4.5 million-5.6 million) people are living with HIV.[5] China, Indonesia and India account for 78% of new infections in the region.[5] National adult (1549 yrs) HIV prevalence is 0.26% (0.22 – 0.32%) in 20156 with HIV seroreactivity as 0.2% in blood donations in NACO supported blood banks.[4] India is considered to have intermediate level of Hepatitis B Virus (HBV) endemicity[7] having 3-4.2% of prevalence with more than 40 million HBV carriers.[8] Hepatitis C Virus (HCV) infection in India has a population prevalence of 1%.9. Despite the mandatory screening of blood with newest, very sensitive serological test, considerable risk remains for transfusion transmission of virus due to window period infections. Study was aimed to analyze the efficacy of Mini pool Nucleic Acid Amplification Testing as additional donor screening program and its role in improving blood safety in the high prevalence population
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