Yield of HCV and HIV-1 NAT after screening of 3.6 million blood donations in central Europe.
BACKGROUND
HCV and HIV-1 NAT of all blood donations was initiated at our institutions in January 1997 to reduce the residual risk of transfusion-transmitted virus infections. The yield of NAT after testing more than 3.6 million donations in central Europe is reported.


METHODS
Automated pipetting instruments were used to pool up to 96 donor samples including those that were antibody reactive. To compensate for dilution of the individual donor samples by pooling, viruses were enriched from the pools by centrifugation at 48,000 x g. A commercial PCR (Cobas Amplicor, Roche) and an in-house PCR were applied for HCV and HIV-1 amplification, respectively.


RESULTS
Six HCV and 2 HIV-1 PCR confirmed-positive, antibody-negative donations (yield, 1 in 600,000 and 1 in 1.8 million, respectively) were identified. Thirty-nine and 11 multiple-time donors seroconverted for HCV and HIV, respectively, and look-back procedures were initiated. Archived samples from preseroconversion donations were thawed and retested by single-sample PCR and remained negative. The recipients of the blood components were traced and tested. All traced recipients were negative for HCV and HIV antibodies.


CONCLUSIONS
The yield of NAT in central European Red Cross blood donors was less than expected from theoretical calculations for American and German multiple-time donors. Look-back procedures for HCV and HIV indicated that no donation given before seroconversion of the donor was missed by minipool PCR. Sensitivity of minipool PCR testing after virus enrichment seems to be sufficiently high to close the diagnostic window almost completely.
Roth
W Kurt
WK
Institute of Transfusion Medicine and Immunohematology German Red Cross, Hesse, Frankfurt.
Weber
Marijke
M
Buhr
Sylvia
S
Drosten
Christian
C
Weichert
Wolfgang
W
Sireis
Walid
W
Hedges
Doris
D
Seifried
Erhard
E
D000914:Antibodies, Viral / Q000097:blood; D001782:Blood Donors; D005060:Europe; D015658:HIV Infections / Q000175:diagnosis / Q000635:transmission; D018023:HIV Seronegativity; D006679:HIV Seropositivity; D015497:HIV-1 / Q000235:genetics* / Q000276:immunology; D016174:Hepacivirus / Q000235:genetics* / Q000276:immunology; D006526:Hepatitis C / Q000175:diagnosis / Q000635:transmission; D006801:Humans; D008403:Mass Screening; D021141:Nucleic Acid Amplification Techniques / Q000592:standards*; D012367:RNA, Viral / Q000097:blood*; D012680:Sensitivity and Specificity
D000914:Antibodies, Viral; D012367:RNA, Viral