Hepatitis E virus blood donor NAT screening: as much as possible or as much as needed?
Transfusion
; 59(2): 612-622, 2019 02.
Article
in En
| MEDLINE
| ID: mdl-30548866
ABSTRACT
BACKGROUND:
The cost-benefit question of general screening of blood products for the hepatitis E virus (HEV) is currently being discussed. One central question is the need for individual nucleic acid amplification techniques (NAT) screening (ID-NAT) versus minipool NAT screening (MP-NAT) approaches to identify all relevant viremias in blood donors. Here, the findings of ID-NAT versus MP-NAT in pools of 96 samples were compared. STUDY DESIGN ANDMETHODS:
From November 2017 to January 2018, a total of 10,141 allogenic blood donations from 7650 individual German blood donors were screened for the presence of HEV RNA using MP-NAT (96 samples) (RealStar HEV RT-PCR Kit) compared to ID-NAT (cobas HEV assay) on the fully automated cobas 6800 platform.RESULTS:
Parallel screening of MP (n = 122, 96 samples/MP) using both methods detected seven reactive pools. After pool resolution, 8 HEV RNA-positive donations were identified by the in-house detection method, whereas 17 HEV RNA-positive donations were identified by ID-NAT with the cobas HEV assay. This resulted in an incidence of 11268 donations (0.079%) for MP-NAT screening and 1597 donations (0.168%) for ID-NAT screening.CONCLUSIONS:
The detection frequency of HEV RNA was approximately 50% higher if ID-NAT was used compared to MP-NAT. However, viral loads of ID-NAT-only samples were below 25 IU/mL and will often not result in transfusion-transmitted HEV (TT-HEV) infection, taking into account the currently known infectious dose of 5.0E + 04 IU inevitably resulting in TT-HEV infection. The clinical relevance and need for identification of these low-level HEV-positive donors still require further investigation.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Blood Donors
/
Hepatitis E virus
/
Hepatitis E
/
Nucleic Acid Amplification Techniques
Type of study:
Diagnostic_studies
/
Prognostic_studies
/
Screening_studies
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Transfusion
Year:
2019
Document type:
Article
Affiliation country:
Germany