One window-period donation in two years of individual donor-nucleic acidtest screening for hepatitis B, hepatitis C and human immunodeficiencyvirus

Revista Brasileira de Hematologia e Hemoterapia

Jose Eduardo Levi¹  Ricardo Antonio D'almeida Pereira¹  Marcia Bernardino De Carvalho Polite¹  Mariza Aparecida Mota¹  Silvia Patricia Nunez¹  Joao Renato Rebello Pinho¹  Jose Mauro Kutner¹ 

关键词: Hepatitis C virus;    HIV;    Hepatitis B virus;    Blood donors;    Hepatitis B/diagnosis;    Hepatitis C/diagnosis;    Reverse transcriptase polymerase chain reaction;   

DOI  :  10.5581/1516-8484.20130039

来源: SciELO

【 摘 要 】

Objective: To describe general data on nucleic acid/serology testing and report the first hepatitis B-nucleic acid testing yield case of an immunized donor in Brazil. Methods: A total of 24,441 donations collected in 2010 and 2011 were submitted to individual nucleic acid testing for hepatitis B, hepatitis C and human immunodeficiency virus using the TaqMan® MPX kit (Roche) on the Cobas s201 platform, in addition to routine screening for serological markers. Nucleic acid testing-reactive donations were further evaluated by real-time polymerase chain reaction using Cobas AmpliPrep/Cobas TaqMan hepatitis B virus, hepatitis C virus and human immunodeficiency virus tests. Results: Thirty-two donations were reactive by nucleic acid testing, 31 were also serologically reactive and one first-time donor was identified as having hepatitis B in the window period. Follow-up samples showed increasing titers of anti-HBs rising from 19 UI/mL in the index donation to 109 IU/mL seven months later attributable to his vaccination history. Curiously, this donor was never reactive for HbsAg nor for anti-HBc. In the yield donation, he was concomitantly reactive for syphilis (enzyme immunoassay and fluorescent treponemal antibody-absorption; venereal disease research laboratory non-reactive). Overall, six donors (0.02%) were characterized as occult hepatitis B. A total of 35% of the confirmed (recombinant immunoblot assay positive) hepatitis C donations were nucleic acid testing non-reactive and no human immunodeficiency virus "elite controller" was identified.Conclusion: The yield rate (1:24,441; 95% confidence interval: 1:9,537 - 1:89,717) contrasts to the North American rate (1:410,540 donations) and strongly advocates the adoption of nucleic acid testing for hepatitis B in Brazil despite the increasing rate of anti-HBs reactive subjects due to the successful immunization program.

【 授权许可】

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