Estimating window period blood donations for human immunodeficiency virus <scp>T</scp>ype 1, hepatitis <scp>C</scp> virus, and hepatitis <scp>B</scp> virus by nucleic acid amplification testing in Southern <scp>P</scp>akistan

Moiz, Bushra; Moatter, Tariq; Shaikh, Usman; Adil, Salman Naseem; Ali, Natasha; Mahar, Farheen Karim; Shamsuddin, Naseem; Khurshid, Mohammad

doi:10.1111/trf.12521

Cited by 16 publications

(30 citation statements)

References 25 publications

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“…Another study found a risk of one in 1515 donations for HIV and of one in 329 donations for HCV . In Pakistan, after NAT implementation, the residual risks are one in 62,600 of HIV and one in 13,900 of HCV …”

Section: Discussionmentioning

confidence: 99%

Residual risk of transmission of human immunodeficiency virus and hepatitis C virus infections by blood transfusion in northern Brazil

Vieira¹,

Lamarão²,

Amaral

et al. 2017

Transfusion

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BACKGROUND Nucleic acid test (NAT) blood screening for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) was introduced in northern Brazil in July 2012. There are several Brazilian articles that have evaluated transfusion transmission risks for HIV and HCV. However, to our knowledge, this article is the first to evaluate the impact of HIV and HCV NAT implementation for blood screening in northern Brazil. The aim of this study was to determine the prevalence and incidence rates of HIV and HCV among blood donors and to compare the residual risk of transfusion transmission of these infections, before (2009‐2011) and after (2012‐2014) NAT implementation. STUDY DESIGN AND METHODS HIV and HCV prevalence and incidence were calculated based on rates of confirmed positive samples. Residual risk estimates were based on the incidence and window model described previously. Logistic and Poisson regressions were used in the statistical analysis. A p value of not more than 0.05 was considered significant. RESULTS HIV and HCV prevalence were 209.9 and 66.3 per 100,000 donations, respectively. Residual risk for HIV and HCV decreased significantly throughout the two study periods, mainly for HCV in which the reduction was one in 169,492 to one in 769,231 donations. For HIV, the decrease was one in 107,527 to one in 769,231 donations. HIV and HCV incidence rates were 21.13 and 3.06 per 100,000 persons/year before NAT and 14.03 and 2.65 per 100,000 persons/year after NAT. CONCLUSION The HIV and HCV NAT implementation significantly increased the transfusion safety in northern Brazil, bringing benefits to recipients due to better quality of blood products produced.

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Section: Discussionmentioning

confidence: 99%

Residual risk of transmission of human immunodeficiency virus and hepatitis C virus infections by blood transfusion in northern Brazil

Vieira¹,

Lamarão²,

Amaral

et al. 2017

Transfusion

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“…2 copies/mL) has a nearly 100% probability to be infectious when 20 mL of plasma in an RBC component is transfused; one therefore can assume that 100% of WP donations would have been infectious with a MID 50 of 3.2 virions. In our study, only two of 23 (9%) WP samples had VL below the qPCR quantification limit, whereas in a recent study from Southern Pakistan, 16/27 (59%) TaqMan qPCR–reactive WP donations reportedly had VLs below the quantification limit; we suspect that a large proportion of the latter cases represented false‐positive NAT results that resulted in an HCV‐NAT–yield rate (1:1530) that was higher than in our study (1:7485). In countries where donor follow‐up for confirmation of NAT‐yield donations is not feasible we recommend the use of the FFP unit for careful preparation of archive samples for confirmation testing to avoid false‐reactive NAT results due to contamination.…”

Section: Discussionmentioning

confidence: 99%

Viremia levels in hepatitis C infection among Egyptian blood donors and implications for transmission risk with different screening scenarios

Ekiaby¹,

Moftah

Goubran

et al. 2015

Transfusion

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BACKGROUND Knowledge about the viral load (VL) distributions in different stages of hepatitis C virus (HCV) infection is essential to compare the efficacy of serologic screening and nucleic acid testing (NAT) in preventing transfusion transmission risk. We studied HCV‐RNA levels in Egyptian blood donors in the preseroconversion window period (WP) and in later anti‐HCV–positive stages of infection. STUDY DESIGN AND METHODS Subsets of individual‐donation (ID)‐NAT and anti‐HCV–yield samples from a screening study among 119,756 donors were tested for VL by quantitative polymerase chain reaction (qPCR). Low viremia levels below the quantification limit of qPCR were determined by probit analysis using the proportion of reactive results on replicate NATs. Poisson distribution statistics were used to estimate transmission risk in different stages of HCV infection based on 50% minimum infectious doses (MID50) of 3.2 (1‐10) and 316 (100‐1000) virions in the absence and presence of anti‐HCV, respectively. RESULTS Rates of total HCV infections and WP‐NAT–yield donations in two Egyptian blood centers varied between 2.6% to 4.5% and 1:3100 to 1:9500, respectively. VLs ranged from 82 to 3 × 107 copies/mL in WP and from fewer than 1600 to 1.6 × 106 copies/mL in anti‐HCV–positive carrier donations. Only two (1.1%) of 175 donors with probable resolved infection had detectable RNA on replicate testing (estimated VLs of 0.5 and 1.8 copies/mL). This translates to an estimated transmission risk of 0.028% if ID‐NAT‐nonreactive, anti‐HCV–positive donations would be used for RBC transfusions. CONCLUSION Almost 99% of anti‐HCV–reactive donations without detectable HCV‐RNA on initial ID‐NAT screening had eradicated the virus from the circulation, while 1% had extremely low VLs and are likely not infectious. The incremental safety offered by serologic testing of ID‐NAT–screened blood seems minimal.

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“…This clearly demonstrates the high value of the combined serological and nucleic acid screening of blood donors. Based on these, other countries have established, along with serological screening, parallel nucleic acid testing of donated blood, conferring more safety for blood supply [19,20]. Despite the high cost of this screening combination, it remains cost-effective given the extra safety that it confers to blood transfusion.…”

Section: Discussionmentioning

confidence: 99%

“…However, the inadequate sensitivity of these assays to detect these viruses during the window periods of the infections poses a major threat of infected blood units getting into the blood supply undetected. A number of countries have established, along with serological screening, parallel nucleic acid testing of donated blood [19,20].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of serological markers and nucleic acid for blood-borne viral infections in blood donors in Al-Baha, Saudi Arabia

Almutairi

AlAhmari²,

Al-Zahran³

et al. 2016

J Infect Dev Ctries

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Introduction: Data on blood-borne viral infections in some regions in Saudi Arabia remain scarce. This study investigates the prevalence of serological markers and nucleic acid for blood-borne viruses among blood donors in Al-Baha, Kingdom of Saudi Arabia. Methodology: In this cross-sectional study, 2,807 donors who donated blood between January 2009 and November 2011 were investigated for blood-borne viral serological markers including HBsAg, anti-HBc, anti-HBs, anti-HCV, anti-HIV, and anti-HTLVI/III in addition to viral nucleic acid. Results: All donors were males between 16 to 66 years of age (mean: 31.5 ± 9.3 years). Viral nucleic acid and/or serological markers were detected in a total of 36 (1.3%) donors; of them, 26 (72.2%) had nucleic acid concomitant with serological markers, 6 (16.7%) had only viral nucleic acid, while 4 (11.1%) had only serological markers. Of all donors, 22 (0.8%) had HBsAg, 227 (8.0%) had anti-HBc, 157 (5.0%) had anti-HBs, 2,577 (91.8%) had no HBV markers, 2 (0.07%) had anti-HIV, 1 (0.04%) had anti-HCV, and 1 (0.04%) had anti-HTLVI/II. The donors who were born during HBV vaccination era showed no HBsAg (0.0%; p = 0.052), lower rates of anti-HBc (1.5%; p < 0.001) and antiHBs (0.7%; p < 0.001), while the majority had no HBV markers (98.5%; p < 0.001). Conclusions: Combined viral nucleic acid and serological testing of donated blood enhances blood safety. The absence of HBV markers among donors suggests susceptibility or declined anti-HBs levels. Thus, HBV revaccination or a vaccine boost among adolescents and adults might be indispensable.

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Estimating window period blood donations for human immunodeficiency virus Type 1, hepatitis C virus, and hepatitis B virus by nucleic acid amplification testing in Southern Pakistan

Cited by 16 publications

References 25 publications

Residual risk of transmission of human immunodeficiency virus and hepatitis C virus infections by blood transfusion in northern Brazil

Residual risk of transmission of human immunodeficiency virus and hepatitis C virus infections by blood transfusion in northern Brazil

Viremia levels in hepatitis C infection among Egyptian blood donors and implications for transmission risk with different screening scenarios

Prevalence of serological markers and nucleic acid for blood-borne viral infections in blood donors in Al-Baha, Saudi Arabia

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