title: Individual donor nucleic acid testing for blood safety against HIV-1 and hepatitis B and C viruses in a tertiary care hospital.
abstract: BACKGROUND
  In July 2010, we started universal individual donor nucleic acid testing (ID-NAT) at our blood bank. This test simultaneously detects human immunodeficiency virus-1 (HIV-1), hepatitis B virus (HBV) and hepatitis C virus (HCV) in samples of donor blood. We continued to do the enzymelinked immunosorbent assay (ELISA) test for these agents, as per the guidelines of the Drug Controller General of India. We assessed the impact of ID-NAT in preventing transfusionassociated transmission of viruses.
  
  
  METHODS
  We used fourth generation ELISA to screen blood samples of all voluntary and replacement blood donors. ID-NAT was done by transcription-mediated amplification (TMA).
  
  
  RESULTS
  Of the 18 356 donors, ID-NAT could not be performed on 2 samples which were inadequate. Of the 18 354 donors tested by both ID-NAT and fourth generation ELISA, 7 were found to be NAT-positive but ELISA-negative (NAT yield) for HBV and HCV. The prevalence of NAT yield cases among routine donors was 1 in 2622 donations tested (0.038%). Since we supply blood as components (packed red cells, fresh frozen plasma and platelet concentrate), these 7 units of blood would have yielded 21 components and hence 21 patients could have been infected with HBV and HCV viruses.
  
  
  CONCLUSIONS
  In the vast majority of blood units tested, the results of ELISA and ID-NAT for HIV-1, HBV and HCV were concordant. ID-NAT did detect the presence of viruses missed by ELISA in some blood units. It widespread use in blood banks would ensure safer blood transfusion.
authors.affiliation: Department of Transfusion Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. kabita.chatterjee@gmail.com
authors.forename: K
authors.initials: K
authors.lastname: Chatterjee
authors.forename: P
authors.initials: P
authors.lastname: Coshic
authors.forename: M
authors.initials: M
authors.lastname: Borgohain
authors.lastname: Premchand
authors.forename: R M
authors.initials: RM
authors.lastname: Thapliyal
authors.forename: S
authors.initials: S
authors.lastname: Chakroborty
authors.forename: S
authors.initials: S
authors.lastname: Sunder
mesh_terms: D000293:Adolescent; D000328:Adult; D001771:Blood Banks / Q000592:standards*; D001782:Blood Donors; D001800:Blood Specimen Collection; D004279:DNA, Viral / Q000097:blood*; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification*; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification*; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood*; D062606:Tertiary Care Centers / Q000592:standards*; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D012367:RNA, Viral