ABSTRACT
BACKGROUND: Use of nucleic acid testing (NAT) in donor infectious disease screening improves transfusion safety. Advances in NAT technology include improvements in assay sensitivity and system automation, and real-time viral target discrimination in multiplex assays. This article describes the sensitivity and specificity of cobas MPX, a multiplex assay for detection of human immunodeficiency virus (HIV)-1 Group M, HIV-2 and HIV-1 Group O RNA, HCV RNA, and HBV DNA, for use on the cobas 6800/8800 Systems. STUDY DESIGN AND METHODS: The specificity of cobas MPX was evaluated in samples from donors of blood and source plasma in the United States. Analytic sensitivity was determined with reference standards. Infectious window periods (WPs) before NAT detectability were calculated for current donor screening assays. RESULTS: The specificity of cobas MPX was 99.946% (99.883%-99.980%) in 11,203 blood donor samples tested individually (IDT), 100% (99.994%-100%) in 63,012 donor samples tested in pools of 6, and 99.994% (99.988%-99.998%) in 108,306 source plasma donations tested in pools of 96. Seven HCV NAT-yield donations and one seronegative occult HBV infection were detected. Ninety-five percent and 50% detection limits in plasma (IU/mL) were 25.7 and 3.8 for HIV-1M, 7.0 and 1.3 for HCV, and 1.4 and 0.3 for HBV. The HBV WP was 1 to 4 days shorter than other donor screening assays by IDT. CONCLUSION: cobas MPX demonstrated high specificity in blood and source plasma donations tested individually and in pools. High sensitivity, in particular for HBV, shortens the WP and may enhance detection of occult HBV.
Subject(s)
Blood Donors , Donor Selection/methods , HIV Infections , HIV/genetics , Hepacivirus/genetics , Hepatitis B virus/genetics , Hepatitis B , Hepatitis C , Nucleic Acid Amplification Techniques , Female , HIV Infections/blood , HIV Infections/genetics , Hepatitis B/blood , Hepatitis B/genetics , Hepatitis C/blood , Hepatitis C/genetics , Humans , Male , Nucleic Acid Amplification Techniques/instrumentation , Nucleic Acid Amplification Techniques/methods , Sensitivity and SpecificityABSTRACT
BACKGROUND: The cobas TaqScreen West Nile virus (WNV) test (Roche Molecular Systems) was licensed by the Food and Drug Administration (FDA) in August 2007 for detecting WNV RNA in pools of six or in individual donations (IDs). A series of studies established the performance characteristics of the assay and test system before FDA licensure. STUDY DESIGN AND METHODS: Analytic sensitivity was determined by probit analysis using multiple source materials. Clinical sensitivity was determined by testing a panel of 315 known WNV RNA-positive specimens. A large clinical specificity study was conducted by five laboratories during months when WNV activity was not expected. RESULTS: The 95 percent limit of detection for ID testing using the Lineage 1 Health Canada WNV reference standard was 40.3 copies per mL (95% individual donation, 35.1-47.8 copies per mL). Clinical sensitivity was 100 percent (95% confidence interval [CI], 98.8%-100%) for ID testing and 97.5 percent (95% CI, 95.1-98.9%) for minipool (MP) testing. Clinical specificity, when resolved to the ID, was 100 percent for both formats and was 99.986 percent at the MP level. CONCLUSION: The cobas TaqScreen WNV test performed on the cobas s 201 system is a fully automated test system with excellent clinical sensitivity and specificity that offers the benefits of automated sample preparation and a secure environment for donor testing information.
