The current status of HCV, HIV, HBV NAT screening Ewa Brojer Institute of Hematology and Blood Transfusion, Warsaw, Poland

1
The current status of HCV, HIV, HBV NAT
screening Ewa Brojer Institute of Hematology
and Blood Transfusion, Warsaw, Poland

• Serology - anti-HCV. anti-HIV, HBsAg
• NAT - HCV RNA - since 2000
• HIV RNA
• HBV DNA

• no anti-HBc

38.5 mln - population 1mln donations/year
since 2005
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HCV NAT results (March 2000 - Dec 2004)
3
High frequency of HCV window period donors in
Poland (2000-2004)
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Study of HCV window period donors

• anti-HCV seroconversion in all donors
• introduction of epidemiological questionaire to
  identify the source and date of infection
• look back studies of all repeat donors

5
HCV RNA detection in look back samples of HCV
RNA positive/anti-HCV negative repeat blood
donors
6
Since 2005 - HBV, HCV and HIV NAT

• Cobas Ampliscreen (Roche)
• 24 donation plasma pools
• TMA HCV/HIV/HBV (Chiron)
• single donations

• Reference Lab IHBT, Warsaw
• certification for all NAT Laboratories

7
Why HBV DNA testing in pools not larger than 24
donations?

• Effectivity of plasma pool Cobas Ampliscreen
  testing revealed in preliminary study
• 2 HBV DNA positives/60 000 dodations tested in
  24 donation pools
• No preliminary studies with TMA single donation
  testing
• Higher sensitivity of Cobas Ampliscreen than
  Chiron TMA
• Lower price in tenders

8
HBV DNA detection in HBsAg negative blood donors
Discrepancies between ULTRIO and HBV
Discrimination
9
Serological and molecular characteristics of HBV
DNA ()/HBsAg(-) donors
with participation of dr Zaaijer, dr Koppelman
and dr Laperche HBsAg pos in PRISM test
Detected by mini-pool testing, single dontion
testing
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Examples of HBV Ultrio discrepant samples
Nuclisens Extractor (Organon Tecnika)
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Examples of HBV DNA detection in Ultrio
discrepant samples
Nuclisens Extractor (Organon Technika)
12
Algorithm for HBV DNA detection in HBsAg negative
donors
ULTRIO () HBV Discrimination ()
ULTRIO ( ) Discrimination (-)
Donor is HBV DNA positive
Repeat ULTRIO
(-)
Donor is HBV DNA negative
() Cobas Ampliscreen DNA from 2 ml of plasma by
Nuclisens Extractor
()
(-)