Vrielink H, Zaaijer H L, Van der Poel C L, Quan S, Cuypers H T, Rios M, Lelie P N, Polito A, Sra K, DiNello R, Pichuantes S, Larson D, Reesink H W
Red Cross Blood Bank Amsterdam, The Netherlands.
Vox Sang. 1996;70(2):114-6. doi: 10.1111/j.1423-0410.1996.tb01303.x.
In The Netherlands, anti-human T-cell lymphotropic virus type I (HTLV-I) blood donor screening became mandatory in January 1993. Donations reactive in the enzymelinked immunosorbent assay (ELISA) screening test are confirmed with Western blot analysis (WB). Only WB-positive or indeterminate blood donors are notified and retested by polymerase chain reaction (PCR) [1]. In accumulated data of the Dutch Blood Banks, only 2% of donors repeatedly positive in the anti-HTLV-I/II ELISA were WB-positive and all of these were also PCR-positive. However, 75% of the ELISA-positive blood donors have indeterminate WB results. In these cases the ELISA reactivities are nonspecific since all WB-indeterminate donors are negative in PCR [2]. Current WB confirmation thus leads to the notification and often to the deferral of many WB-indeterminate blood donors as well as to high costs for PCR testing, illustrating the need for a more specific serological confirmatory assay. The aim of our study was to evaluate a newly developed anti-HTLV-I/II Recombinant Immunoblot Assay (RIBA) to confirm samples reactive to screening tests with a special emphasis on the ability of this test to resolve WB-indeterminate results in blood donors, without compromising the sensitivity.
在荷兰，1993年1月起对献血者进行抗人类嗜T细胞病毒I型（HTLV-I）筛查成为强制性要求。酶联免疫吸附测定（ELISA）筛查试验中呈反应性的献血样本通过蛋白质印迹分析（WB）进行确认。只有WB呈阳性或结果不确定的献血者会收到通知，并通过聚合酶链反应（PCR）进行重新检测[1]。在荷兰血库的累积数据中，抗HTLV-I/II ELISA多次呈阳性的献血者中只有2%的WB呈阳性，且所有这些献血者的PCR检测也呈阳性。然而，75%的ELISA呈阳性的献血者WB结果不确定。在这些情况下，ELISA的反应性是非特异性的，因为所有WB结果不确定的献血者PCR检测均为阴性[2]。因此，目前的WB确认导致许多WB结果不确定的献血者收到通知并常常被延期献血，同时PCR检测成本高昂，这表明需要一种更具特异性的血清学确认检测方法。我们研究的目的是评估一种新开发的抗HTLV-I/II重组免疫印迹试验（RIBA），以确认对筛查试验呈反应性的样本，特别强调该试验在不影响敏感性的情况下解决献血者WB结果不确定问题的能力。
