Department of Transfusion Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
Indian J Med Res. 2019 May;149(5):633-640. doi: 10.4103/ijmr.IJMR_822_17.
BACKGROUND & OBJECTIVES: Individual donation nucleic acid testing (ID-NAT) is considered as sensitive technology to assess blood safety from viral transfusion-transmissible infections (TTIs) in blood donors. The present study was aimed to analyze the results of ID-NAT for three years (2013-2015) with special reference to different types of donors and their age ranges in a tertiary care centre in north India.
The results of ID-NAT for three years were retrospectively analyzed at our centre. A total of 168,433 donations were tested with ID-NAT, of which 10,467 were tested with Procleix Ultrio reagents and 157,966 were tested with ProcleixUltrioPlus reagents, and the results were compared with those of serology to calculate the NAT yield in voluntary, replacement, first-time and repeat donors.
A combined NAT yield was observed as one in 1031 out of 167,069 seronegative donations with HBV yield as one in 1465, HCV yield as one in 3885 and HIV-1 as one in 167,069. Yield for co-infection (HCV and HBV) was one in 41,767. A high NAT yield was observed in replacement donors (1 in 498) as compared to voluntary donors (1 in 1320).
INTERPRETATION & CONCLUSIONS: Addition of NAT to serology improved the blood safety in our centre interdicting possibility of 150 TTIs annually. It has also reemphasized the safety of voluntary over replacement donors. The results also highlight the need of proper counselling, notification and referral guidelines of NAT yield donors in our country and other countries which lack them.
个体供者核酸检测(ID-NAT)被认为是一种敏感技术,可用于评估献血者经血液传播感染性病毒(TTVI)的血液安全性。本研究旨在分析印度北部一家三级护理中心 3 年来(2013-2015 年)ID-NAT 的检测结果,特别参考了不同类型供者及其年龄范围。
对本中心 3 年来 ID-NAT 的检测结果进行回顾性分析。共对 168433 份献血进行了 ID-NAT 检测,其中 10467 份采用 Procleix Ultrio 试剂进行检测,157966 份采用 ProcleixUltrioPlus 试剂进行检测,并与血清学检测结果进行比较,以计算自愿、替代、初次和重复供者中 NAT 的检出率。
在 167069 份 HBV 血清学阴性献血中,联合 NAT 检测出 1 例,HBV 检出率为 1/1465,HCV 检出率为 1/3885,HIV-1 检出率为 1/167069。HCV 和 HBV 合并感染的检出率为 1/41767。与自愿供者(1/1320)相比,替代供者的 NAT 检出率较高(1/498)。
血清学联合 NAT 检测提高了本中心的血液安全性,每年可避免 150 例 TTVI 的发生。它还再次强调了自愿供者优于替代供者的安全性。结果还强调了在我国和其他缺乏 NAT 检测结果国家制定适当的咨询、通知和 NAT 检出率供者转诊指南的必要性。