Five years of experience with ID‐NAT at a tertiary care centre in North India: An interdictory step in preventing the transfusion‐transmitted Infections

Abstract

Introduction Technological advancements in transfusion medicine have led to safer blood supply to the community like never before. However, blood safety is a daunting task in India with ~1.25 billion population and high prevalence rate of HIV (0.29%), HBV (2–8%) and HCV (2%) in donor population. This study aims at evaluating the impact of ID‐NAT as an add‐on test on safe blood supply in the current Indian scenario. Materials and Method A retrospective observational study was conducted to analyse the data of 5 years of add‐on NAT at Main Blood Bank, AIIMS, New Delhi. Results 1.84% (3556 of 193 167) units were initially NAT reactive. A total of 3495 units were further tested, of which 79.25% were discriminated (193 HIV, 421 HCV, 2060 HBV and 96 co‐infections). The remaining 13% (456) were repeat non‐reactive and 7.7% (269) could not be discriminated. Overall, NAT yield rate was one in 847, whereas virus‐specific NAT yield rates were one in 96 584, one in 2683, one in 1370 and one in 14 859 for HIV, HCV, HBV and HBV/HCV Co‐infections, respectively. Conclusion Five‐years of ID‐NAT screening interdicted 228 probable TTIs to 684 (assuming 100% component separation) transfusion recipients. Implementation of NAT along with routine serological tests for screening of the blood donations definitely improves the transfusion safety. However, interpretation of NAT reactive results should be adjudged cautiously keeping in mind, the chance occurrence of false‐positive reactivity.

Initial trends of individual donation nucleic acid testing in voluntary & replacement donors from a tertiary care centre in north India

“…In our study, only discriminated samples were considered as true NAT yield excluding samples which were IR but did not discriminate; however, these donation units were removed from the inventory as done by Makroo et al 8. In a five-year experience of NAT, Chatterjee et al 28 mentioned 13.04 per cent NAT-IR units to be non-reactive with the primary pilot tube itself on repeat testing and 0.71 per cent NAT-IR units were found to have at least one repeat reactive result, even then 6.98 per cent NAT-IR units in their study could not be discriminated. In our study, 59 per cent samples were NAT-IR but not discriminated, of which 44 per cent samples were repeated in triplicate from plasma bag after thawing which were repeat non-reactive, remaining could not be repeated from plasma bags because those were discarded before sampling for repeat NAT.…”

“…In our study, 59 per cent samples were NAT-IR but not discriminated, of which 44 per cent samples were repeated in triplicate from plasma bag after thawing which were repeat non-reactive, remaining could not be repeated from plasma bags because those were discarded before sampling for repeat NAT. There was difference between our NAT algorithm and algorithm of Chatterjee et al 28 as they did discriminatory testing in triplicate whereas we performed discriminatory test for single time. Previous studies from India (Table VII) did not mention their NAT protocol so could not be compared with our algorithm.…”

NAT yield in blood donors: An observational study

“…The NAT yield in this study was lower than that obtained by Kumar R et al ,[ 7 ] Agarwal et al ,[ 8 ] and Kabita C et al . , [ 9 ] which was 1 in 753, 1 in 610, and 1 in 847, respectively.…”