Transfusion Transmissible Infections: Maximizing Donor Surveillance

Area of Science:

• Transfusion Medicine
• Infectious Diseases Epidemiology
• Clinical Laboratory Science

Background:

• The World Health Organization mandates screening of donated blood for Human Immunodeficiency Virus (HIV), Hepatitis B, Hepatitis C, and Syphilis.
• Mandatory malaria screening is recommended in endemic regions.
• Understanding the prevalence of transfusion-transmitted infections (TTIs) and evaluating diagnostic methods is crucial for blood safety.

Purpose of the Study:

• To analyze the prevalence of TTIs among replacement and voluntary blood donors.
• To compare different diagnostic methods for screening TTIs.
• To assess the effectiveness of screening in a tertiary care hospital in Islamabad, Pakistan.

Main Methods:

• A cross-sectional study involving 30,470 blood donors from July 2015 to October 2017.
• Initial screening using serological tests for HIV types 1 & 2, Hepatitis B, and Hepatitis C.
• Nucleic Acid Amplification Test (NAT) for seronegative samples; Immuno-chromatographic tests for malaria; Electrochemiluminescence immunoassay for syphilis antibodies.

Main Results:

• A total of 997 (3.27%) donors were infected with at least one TTI.
• Seroprevalence: Hepatitis C (1.29%), Hepatitis B (1.06%), Syphilis (0.75%), HIV (0.16%).
• NAT detected additional infections: Hepatitis B virus DNA (0.03%), Hepatitis C virus RNA (0.01%); no HIV detected by NAT. Malaria prevalence was 0.02%.

Conclusions:

• Standardized blood component screening is effective in preventing TTI transmission.
• Nucleic Acid Amplification Test (NAT) demonstrates superior sensitivity over serological tests in reducing the residual risk of transfusion-transmitted infections.
• The study highlights the importance of advanced screening methods for ensuring blood transfusion safety.