title: Impact of nucleic acid amplification test on screening of blood donors in Northern Pakistan.
abstract: BACKGROUND
  The Armed Forces Institute of Transfusion located in Rawalpindi, Northern Pakistan, acts as a regional blood center with more than 50,000 donations collected annually. Nucleic acid amplification testing (NAT) was introduced in our institution in September 2012 for screening all seronegative blood donors.
  
  
  METHODS
  The study was conducted from September 21, 2012, to September 20, 2013. Samples from the seronegative donors were run on cobas s 201 platform (Roche) in pools of six. Reactive donors were followed up for further confirmatory testing to rule out false-positive results. Viral load estimation was done for all NAT-reactive donors.
  
  
  RESULTS
  After serologic screening of 56,772 blood donors, 2334 were found to be reactive; 719 (1.27%) were reactive for hepatitis B surface antigen, 1046 (1.84%) for antibody to hepatitis C virus (anti-HCV), 12 (0.02%) for antibody to human immunodeficiency virus, and 557 (0.98%) for syphilis antibodies. A total of 27 NAT-reactive donors were confirmed after testing 54,438 seronegative donors, with an overall NAT yield of one in 2016 donors: 23 for hepatitis B virus (HBV) DNA (HBV NAT yield, 1:2367) and four for HCV RNA (HCV NAT yield, 1:13,609). The residual risk after NAT implementation, calculated for the first-time blood donors, was 62.5 and 4.4 per million donors for HBV and HCV, respectively.
  
  
  CONCLUSIONS
  NAT has improved the safety of blood products at our transfusion institution. Confirmation of NAT results must always be done either on follow-up samples or on samples from the retrieved frozen plasma bag.
authors: Armed Forces Institute of Transfusion (AFIT).
authors: Saifullah Khan
authors: SK
authors: Niazi
authors: Armed Forces Institute of Transfusion (AFIT).
authors: Farhat Abbas
authors: FA
authors: Bhatti
authors: Armed Forces Institute of Transfusion (AFIT).
authors: Nuzhat
authors: N
authors: Salamat
authors: Armed Forces Institute of Pathology (AFIP), Rawalpindi, Pakistan.
authors: Eijaz
authors: E
authors: Ghani
authors: Armed Forces Institute of Transfusion (AFIT).
authors: Muhammad
authors: M
authors: Tayyab
mesh_terms: D000293:Adolescent; D000328:Adult; D001782:Blood Donors; D058731:Blood Safety / Q000379:methods*; D004279:DNA, Viral / Q000097:blood*; D046148:Donor Selection / Q000379:methods*; D005260:Female; D006511:Hepatitis B Antigens / Q000097:blood; D018936:Hepatitis C Antigens / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D021141:Nucleic Acid Amplification Techniques; D010154:Pakistan; D012367:RNA, Viral / Q000097:blood*
chemical_list: D004279:DNA, Viral; D006511:Hepatitis B Antigens; D018936:Hepatitis C Antigens; D012367:RNA, Viral