Evaluation of a pooling method for routine anti-HCV screening of blood donors to lower the cost burden on blood banks in countries under development

Abstract

A pooling system was developed for use in anti-HCV screening of voluntary blood donors at the local Central American Red Cross blood banks, in Nicaragua, El Salvador and Honduras. The commercially available second generation anti-HCV screening kit from Abbott Laboratories (North Chicago, IL) was used with a modification in the initial serum dilution procedure. Pools of five sera were selected for routine screening, based on comparative studies of individual samples and of pools with different sample sizes. During the years 1993 and 1994 a total of 89, 148 voluntary blood donors were screened and a positive prevalence rate of 0.35% was established. Of the initially positive samples, 54% confirmed positive, 30% were indeterminate and 16% were negative using the Abbott Matrix test. Significant differences of positive screening prevalence rates were found in the three countries, with average values of 0.50%, 0.23% and 0.08%, respectively, in Nicaragua, El Salvador and Honduras. These initially positive samples also showed a different confirmatory pattern with a positive rate of 64% in Nicaragua, in contrast to 20% in El Salvador. Only a few samples were available for RT-PCR amplification of HCV-RNA; however, this highly sensitive method did not appear to be more helpful than serology in confirming the HCV donor status. Overall, the data obtained indicate a fluctuation of HCV prevalence in voluntary blood donors among the three Central American countries. Further, differences were found in the percentages of initially screened positives and confirmation patterns. This information appears useful for establishing criteria in future screening policies. Thus, we suggest that the use of pooling for anti-HCV screening is beneficial in countries under development, since there are potential cost savings, as well as benefits in establishment of initial prevalence rates.

Hepatitis B surface antigen detection using pooled sera: A cost-benefit analysis

“…These findings are similar to those obtained by other investigators who applied the method of pooling to the study of HCV and HIV infection (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). Up to the present, only two studies (20,21) have been reported concerning the application of the pooling method to the study of HBV infection.…”

“…The serum pooling technique attempts to reduce costs without losing efficacy, and has been mainly used in developing countries in the search for antibodies against the human immunodeficiency virus (HIV) (5)(6)(7)(8)(9)(10)(11)(12)(13)(14), and hepatitis C virus (HCV) (15)(16)(17)(18)(19). The results obtained with this method have proved highly promising, as they have significantly decreased the cost of laboratory tests without significantly decreasing their sensitivity.…”

Impact of Hepatitis B and Hepatitis C Virus Infections in a Hematology-Oncology Unit at a Children's Hospital in Nicaragua, 1997 to 1999

“…For blood donors this value varies from 0.3 to 0.6%, and approximately 50% of isolates belong to genotype 1 (8). This earlier study result, taken together with a 0.9% prevalence in HCW determined by this study, eliminates the possibility that children were infected by family members or HCW contacts.…”

Comparison of Microscopy, Nested-PCR, and Real-Time-PCR Assays Using High-Throughput Screening of Pooled Samples for Diagnosis of Malaria in Asymptomatic Carriers from Areas of Endemicity in Myanmar

“…This technique has been successfully applied to blood donor screening for antibodies to HIV (21), hepatitis B virus (22), and hepatitis C virus (23) and to genetic diagnosis of virus infections using PCR (24,25). Recently, this pooling strategy has also been employed to screen malaria parasite infections and compare microscopy and real-time PCR for large numbers of African samples (26), and it may very useful for large-scale surveillance study in countries where malaria is endemic.…”