title: Seroprevalence of human immunodeficiency virus in north Indian blood donors using third and fourth generation Enzyme linked immunosorbent assay.
abstract: BACKGROUND
  The percentage of HIV cases attributable to blood transfusion has decreased significantly in the last decade. The newer 4(th) generation Enzyme linked immunosorbent assay (ELISA) has been shown to have increased sensitivity compared to 3(rd) generation ELISA.
  
  
  OBJECTIVE
  To estimate the seroprevalence of HIV among blood donors using 4(th) generation ELISA assay and to compare it with the 3(rd) generation ELISA.
  
  
  METHODS
  This prospective study involved 10,200 blood donors- 6,800 were voluntary donors (3400-students and 3400-non students) and 3400 were replacement donors. All blood units were tested with 3(rd) as well as 4(th) generation ELISA. All samples found reactive or in grey zone with either 3(rd) or 4(th) generation ELISA were retested by Western blot (WB).
  
  
  RESULTS
  The seroprevalence of HIV was estimated to be 1.37/1000 donations (0.14%) with 3(rd) generation ELISA compared to 3.62/1000 donations (0.36%) with 4(th) generation ELISA (p>0.05). The seroprevalence of HIV among voluntary donors was estimated to be 1.32/1000 donations (0.13%) with 3(rd) generation ELISA and 3.67/1000 donations (0.36%) with 4(th) generation ELISA. The prevalence of HIV among replacement donors was 1.47/1000 donations (0.15%) with 3(rd) generation ELISA and 3.52/1000 donations (0.35%) with 4(th) generation ELISA.
  
  
  CONCLUSIONS
  4(th) generation HIV ELISA detects a higher number of seroreactive donors compared to 3(rd) generation ELISA. However, larger studies are required with confirmatory tests for both 3(rd) and 4(th) generation ELISA for making any policy changes.
authors.affiliation: Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Sheetal
authors.initials: S
authors.lastname: Malhotra
authors.forename: Neelam
authors.initials: N
authors.lastname: Marwaha
authors.forename: Karan
authors.initials: K
authors.lastname: Saluja
keywords: Enzyme linked immunosorbent assay; Human immunodeficiency virus; blood donors; transfusion associated HIV/AIDS; window period