Journal
BLOOD TRANSFUSION
Volume 20, Issue 1, Pages 1-7Publisher
SIMTIPRO SRL
DOI: 10.2450/2021.0032-21
Keywords
HCV; blood donations; NAT; viral load
Categories
Ask authors/readers for more resources
The study analyzed the relevance of maintaining blood screening based on both HCV infection antibodies and nucleic acid testing in France. The results showed a decline in the yield of NAT-positive cases and an increase in donors with antibody-positive but NAT-negative results, implying a growing number of resolved infections. However, retesting revealed that at least 0.5% of antibody-positive but NAT-negative donors had low viral loads, indicating the potential risk of transmission. The findings suggest that retaining antibody screening in blood donation is still necessary in France.
Background -The question of maintaining blood screening based on both Hepatitis C virus (HCV) infection antibodies (Ab) and Nucleic Acid Testing (NAT) has been raised in several countries. The French blood donor surveillance database was used to address this issue. Materials and methods -In France, HCV-NAT was implemented in mini pools (MP) in 2001 and in individual testing (ID) in 2010. HCV-positive donations are further investigated including detection of RNA with an alternative polymerase chain reaction assay: Amplicor HCV v2.0 (Roche; LOD95 50 IU/mL) from 2001 to 2006 and CobasTaqMan (CTM) HCV 2.0 assay (Roche; LOD95 9.3 IU/mL) since 2007. Results -From 2001 to 2018, 3,058/48.8 million donations were confirmed HCV positive: 64.4% were Ab+/NAT+, 35.1% Ab+/NAT- and 0.5% Ab-/NAT+. From 2001 to 2018, the NAT yield decreased from 0.65 per million donations to 0, and NAT+ donations dropped from 77% to 46% of the total of HCV donations. 2,491/3,058 were further tested for HCV-RNA: 1,032 (816 NAT+, 216 NAT-) with Amplicor and 1,459 (897 NAT+, 562 NAT-) with CTM. Four (3 MP and 1 ID-NAT, 0.5%) of the 778 NAT negative donations had low viral loads. Discussion -The decline in HCV-NAT yield cases raises the question of the relevance of NAT. Conversely, the increase in Ab+/NAT- donors, suggesting a growing number of resolved infections, argue for Ab discontinuation. In our experience, at least 0.5% of Ab+/NAT- donations had low RNA level when retested. Although the risk of viral transmission by such donations is probably low, the uncertainty associated with their infectivity goes against the removal of Ab in blood screening in our country.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available