Pathak Sangeeta, Chandrashekhar M
Blood Bank Max Super Speciality Hospital, Saket, New Delhi, India.
Asian J Transfus Sci. 2013 Jul;7(2):116-8. doi: 10.4103/0973-6247.115566.
Transfusion transmittable infections (TTI) continue to be a major threat to safe transfusion practices. Blood is one of the major sources of transmission of infectious diseases viz. human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis, malaria, and many other infections in India. Screening assays for the infectious diseases with excellent sensitivity and specificity helps to enhance the safety of the blood transfusions reducing the diagnostic window period as much as possible.
The present study was designed to determine the seroprevalence of TTIs viz., HIV, HCV, and HBV, among the blood donors in Max Super Specialty Hospital, New Delhi, India based on dual testing strategy using high sensitive screening assays such as enhanced chemiluminescence assay and nucleic acid testing (NAT).
A total of 41207 blood units collected from the donors (both voluntary and replacement donors) were screened for the TTI s, viz., anti HIV 1 and 2 antibody, anti HCV antibody, anti HBcore antibody, and HBsAg by enhanced chemiluminescence assay on VITROS(®) ECiQ immunodiagnostics system. NAT was performed using Roche Cobas(®) TaqScreen MPX assay, which can detect simultaneously HIV 1 (groups M and O), HIV-2, HCV, and HBV on Roche Cobas(®) s201 system.
The seroprevalence of HIV, HBsAg, anti HBcore antibody, and HCV based on enhanced chemiluminescence assay was found to be 0.25, 0.2, 7.06, and 0.7%, respectively. A total number of 6587 samples from July 2010 to December 2010 were tested on NAT, of which 3 samples were reactive for HBV in NAT; this was missed by enhanced chemiluminescence assay.
Based on the seroprevalence study of infectious diseases viz., HIV, HBV, and HCV, we conclude that screening of blood and blood components by dual testing strategy using high sensitivity serological assay like enhanced chemiluminescence technology and NAT helps in detecting the potentially infectious blood units in all phases of infection, which aids in enhancing the safety of blood transfusion and reducing the potential risk of post-transfusion infection.
输血传播感染(TTI)仍然是安全输血实践的一大威胁。在印度,血液是传染病传播的主要来源之一,如人类免疫缺陷病毒(HIV)、乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)、梅毒、疟疾以及许多其他感染。具有出色灵敏度和特异性的传染病筛查检测有助于提高输血安全性,尽可能缩短诊断窗口期。
本研究旨在基于双重检测策略,使用高灵敏度筛查检测方法,如增强化学发光检测和核酸检测(NAT),确定印度新德里马克斯超级专科医院献血者中TTI(即HIV、HCV和HBV)的血清流行率。
对从献血者(包括自愿献血者和替代献血者)采集的总共41207个血液单位进行TTI筛查,即通过在VITROS(®) ECiQ免疫诊断系统上进行增强化学发光检测,检测抗HIV 1和2抗体、抗HCV抗体、抗HBcore抗体以及HBsAg。使用罗氏Cobas(®) TaqScreen MPX检测进行NAT,该检测可在罗氏Cobas(®) s201系统上同时检测HIV 1(M组和O组)、HIV-2、HCV和HBV。
基于增强化学发光检测,HIV、HBsAg、抗HBcore抗体和HCV的血清流行率分别为0.25%、0.2%、7.06%和0.7%。2010年7月至2010年12月期间共有6587个样本进行了NAT检测,其中3个样本在NAT检测中对HBV呈反应性;这在增强化学发光检测中未被检测到。
基于对HIV、HBV和HCV等传染病的血清流行率研究,我们得出结论,采用双重检测策略,使用如增强化学发光技术和NAT等高灵敏度血清学检测方法对血液和血液成分进行筛查,有助于在感染的各个阶段检测出潜在感染性血液单位,这有助于提高输血安全性并降低输血后感染的潜在风险。