Dhiman Yashaswi, Patidar Gopal K, Hazarika Anjali
Department of Transfusion Medicine, Cardio-neuro Centre, All India Institute of Medical Sciences, New Delhi, India.
Transfus Apher Sci. 2019 Aug;58(4):464-467. doi: 10.1016/j.transci.2019.05.013. Epub 2019 Jul 10.
Enzyme linked immunosorbent assay (ELISA) test is used for screening of transfusion transmitted infections (TTI) in blood donors. Consecutive reactive results in ELISA is due to sample/reagent carryover or donor related. In this study we tried to find out the possibilities of family history/close contacts with patients of hepatitis among these consecutive reactive donors.
To analyze the consecutive reactive results in ELISA tests for TTI testing on samples of healthy blood donors.
A retrospective observational study was conducted from January 2016 to July 2018 in a tertiary care hospital, North India. Consecutive reactive results by fourth generation ELISA for TTIs screening were evaluated for possible reasons. Confirmation tests were not done. Reactive donors were contacted telephonically for relevant history of close contact with infected personnel.
Out of 53,740 donations 1,061 were reactive for TTIs during our study period. Prevalence of Hepatitis B (HBV), Human Immunodeficiency (HIV) and Hepatitis C (HCV) virus infection in blood donors were 1.27%, 0.20% and 0.50% respectively. Consecutive reactive results for HBV were 9.20% (63/685), for HCV 6.0% (16/266) and nil for HIV. There was no sample carryover in this. Out of 79 consecutive reactive donors 69 donated for same patients and 32 were related with infected patient which are statistically significant (p < 0.0001).
This study recommends that in analysis of consecutive positive results in ELISA along with looking for procedure/sample error, there is also a need to take retrospective history of donors for close contact with infected patients.
酶联免疫吸附测定(ELISA)试验用于筛查献血者的输血传播感染(TTI)。ELISA中连续出现反应性结果可能是由于样本/试剂残留或与献血者自身有关。在本研究中,我们试图找出这些连续反应性献血者中存在肝炎患者家族史/与肝炎患者密切接触的可能性。
分析健康献血者样本TTI检测中ELISA试验的连续反应性结果。
2016年1月至2018年7月在印度北部一家三级医疗机构进行了一项回顾性观察研究。对第四代ELISA筛查TTI的连续反应性结果评估其可能原因。未进行确认试验。通过电话联系反应性献血者,了解其与感染人员密切接触的相关病史。
在我们的研究期间,53740份献血中有1061份对TTI呈反应性。献血者中乙型肝炎(HBV)、人类免疫缺陷病毒(HIV)和丙型肝炎(HCV)病毒感染率分别为1.27%、0.20%和0.50%。HBV连续反应性结果为9.20%(63/685),HCV为6.0%(16/266),HIV为零。不存在样本残留情况。在79名连续反应性献血者中,69人为同一患者献血,32人与感染患者有关,具有统计学意义(p<0.0001)。
本研究建议,在分析ELISA连续阳性结果时,除了查找操作/样本误差外,还需要追溯献血者与感染患者密切接触的病史。