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Methods for Quantitative Detection of Antibody-induced Complement Activation on Red Blood Cells
Published on: January 29, 2014
Detection of false seroconversions in cytomegalovirus seronegative platelet donors by serial complement fixation or
D J Morris1, P E Klapper, G Cleator
1Department of Pathological Sciences, Medical School, Manchester UK.
Insights
Cytomegalovirus (CMV) antibody testing in blood donors revealed a high rate of transient seroreactivity using the RIST assay. This highlights challenges in accurately detecting latent CMV infection in donors.
Area of Science:
- Virology
- Immunology
- Transfusion Medicine
Background:
- Cytomegalovirus (CMV) is a common virus that can pose risks in transfusion settings.
- Accurate serological testing is crucial for identifying CMV-infected blood donors to prevent transmission.
- Previous methods for CMV antibody detection have limitations in specificity and interpretation.
Purpose of the Study:
- To evaluate the performance of complement-fixation (CFT) and IgG-specific radioimmunosorbent tests (RIST) for detecting CMV seroconversion in platelet donors.
- To assess the rate and nature of CMV seroreactivity in a cohort of initially seronegative donors.
- To propose recommendations for CMV antibody testing strategies in blood donation.
Main Methods:
- Longitudinal follow-up of 421 cytomegalovirus (CMV) seronegative-platelet donors.
- Testing of 2452 serum specimens using complement-fixation (CFT) and IgG-specific radioimmunosorbent tests (RIST).
- Analysis of seroconversion rates and patterns of reactivity over 4623 person-months of observation.
Main Results:
- An annual CMV seroreactivity rate of 56% was detected by RIST, but most positive results were transient.
- Complement-fixation (CFT) seroreactivity was an unreliable predictor of RIST seroreactivity.
- A high incidence of transient RIST reactivity suggests potential issues with test specificity or interpretation of latent infection.
Conclusions:
- The high rate of transient seroreactivity observed with RIST complicates the accurate diagnosis of CMV infection in blood donors.
- Current antibody tests may struggle to differentiate between active infection, past infection, and latent CMV carriage.
- Revised recommendations for CMV antibody testing in blood donors are necessary to improve screening accuracy and donor safety.
Abstract:
A panel of 421 cytomegalovirus (CMV) seronegative-platelet donors was followed using complement-fixation (CFT) and IgG-specific radioimmunosorbent tests (RIST) to detect seroconversion. During 4623 person-months of observation 2452 serum specimens were tested, and the annual rate of seroreactivity detected by RIST was 56%. However, most of the positive RIST results were followed by negative results with later serum samples. CFT seroreactivity was a poor predictor of RIST seroreactivity. The high rate of transient seroreactivity detected by RIST may have reflected the lack of absolute specificity of the test. Alternatively, the results could illustrate the difficulty of determining whether an individual harbours latent CMV infection using antibody tests when some seronegative individuals appear to be latently infected. In the light of our observations recommendations for CMV antibody testing of blood donors are proposed.
