The Brazilian experience of nucleic acid testing to detect human immunodeficiency virus, hepatitis C virus, and hepatitis B virus infections in blood donors

Transfusion. 2018 Apr;58(4):862-870. doi: 10.1111/trf.14478. Epub 2018 Jan 30.

Abstract

Background: The history of the development and implementation of the Brazilian nucleic acid testing (NAT) platform to detect and discriminate among human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV) infections in blood donors is described here. The results for the sensitivity, reproducibility, and NAT yield of the platform since program implementation are provided.

Study design and methods: The Brazilian NAT HIV, HCV, and HBV kit was developed and evaluated with regard to analytical sensitivity, specificity, intralot and interlot reproducibility, interfering substances, and genotype and diagnostic sensitivity. Additionally, a sample of identified NAT-yield cases was characterized with regard to viral load.

Results: The 95% limits of detection for HIV, HCV, and HBV were 68.02, 102.35, and 9.08 IU/mL, respectively. All replicates were detected with reproducibility assays between the acceptable values. A total of 13,610,536 blood donors was screened from 2010 to 2016, and 63 HIV-yield cases and 28 HCV-yield cases were detected. Among 5,795,424 blood donors screened for HBV from 2014 to 2016, 42 yield cases were found.

Conclusion: The Brazilian NAT HIV, HCV, and HBV kit is an automated NAT system suitable for routine blood donor screening in a completely traceable process. The analytical sensitivity as well as the diagnostic sensitivity fulfilled all requirements set by the health ministry for blood donor screening. A significant number of transmission cases were prevented by the implementation of this important program.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Automation
  • Blood Donors*
  • Blood Safety* / instrumentation
  • Blood Safety* / methods
  • Blood Safety* / standards
  • Brazil
  • DNA, Viral / blood*
  • HIV Infections / blood
  • HIV Infections / diagnosis*
  • Hepatitis B / blood
  • Hepatitis B / diagnosis*
  • Hepatitis C / blood
  • Hepatitis C / diagnosis*
  • Humans
  • Mass Screening / methods
  • Real-Time Polymerase Chain Reaction* / instrumentation
  • Real-Time Polymerase Chain Reaction* / methods
  • Real-Time Polymerase Chain Reaction* / standards
  • Reference Standards
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Viral Load
  • Viremia / diagnosis*
  • Viremia / transmission

Substances

  • DNA, Viral