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Three-Year Experience in NAT Screening of Blood Donors for Transfusion Transmitted Viruses in Croatia
Hana Safic Stanic1, Ivana Babic1, Margareta Maslovic1
1Croatian Institute of Transfusion Medicine (CITM), Zagreb, Croatia.
Insights
Croatia
Area of Science:
- Transfusion Medicine
- Virology
- Public Health
Background:
- Croatia mandated individual donation (ID)-NAT testing for HBV, HCV, and HIV-1 in 2013.
- This study evaluates the impact of Nucleic Acid Testing (NAT) screening 3 years post-implementation.
Purpose of the Study:
- To assess the effectiveness of ID-NAT screening in enhancing blood safety in Croatia.
- To determine the prevalence of transfusion-transmissible infections detected by NAT.
Main Methods:
- Screened 545,463 blood donations using the Procleix Ultrio Plus Assay for HBV, HCV, and HIV-1.
- Confirmed initially reactive samples through retesting, discriminatory NAT (dNAT), and RT-PCR.
- Identified NAT-yield cases, including window period infections and occult HBV.
Main Results:
- 108 donations (0.02%) were repeatedly reactive in NAT.
- Identified 82 HBV, 16 HCV, and 10 HIV-1 reactive samples.
- Detected 51 NAT-yield cases: 1 window period HIV-1 and 50 occult HBV infections (OBI), with 2 potential HBV transmissions from OBI donors.
Conclusions:
- NAT screening significantly improved blood safety in Croatia.
- Identified critical cases, including window period HIV-1 and numerous occult HBV donations, underscoring NAT's value.
Background:
Croatia implemented individual donation (ID)-NAT testing of blood donors in 2013 for three viruses HBV, HCV, and HIV-1 as a mandatory test for all blood donors. This study assessed the impact of NAT screening 3 years after its implementation.
Methods:
A total of 545,463 donations were collected and screened for HBV, HCV, and HIV-1 using the Procleix Ultrio Plus Assay. All initially reactive (IR) NAT samples were retested in triplicate and, if repeatedly reactive (RR), NAT discriminatory assay (dNAT) was performed. ID-NAT positive donations were confirmed by RT-PCR on the COBAS AmpliPrep/TaqMan platform.
Results:
Out of 545,463 samples tested, 108 (0.02%) were RR in NAT. There were 82 (75,9%) HBV reactive, 16 (14.8%) HCV reactive, and 10 (9.3%) HIV-1 reactive samples. 51 (47.2%) samples were ID-NAT positive only. Out of these 51 NAT yield cases, 1 window period HIV-1 and 50 occult HBV infections (OBI) were determined. There were only two potential HBV DNA transmissions from OBI donors.
Conclusion:
The implementation of NAT screening for three viruses has improved blood safety in Croatia. During the 3-year period, 1 window period HIV-1 and a number of occult HBV donations were identified.
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