Refinement of a viral transmission risk model for blood donations in seroconversion window phase screened by nucleic acid testing in different pool sizes and repeat test algorithms
- 12 August 2010
- journal article
- Published by Wiley in Transfusion
- Vol. 51 (1), 203-215
- https://doi.org/10.1111/j.1537-2995.2010.02804.x
Abstract
In minipool nucleic acid test (MP-NAT) screening protocols, the donations implicated in reactive test pools are released for transfusion when they are nonreactive in a repeat test on the individual samples, but in individual-donation (ID)-NAT screening algorithms the release of nonrepeatable reactive (NRR) donations is under discussion. A previously developed window phase (WP) transmission risk model for NAT-screened blood transfusions has been refined to take the effect of repeat tests of initially reactive (IR) MP- or ID-NAT results into account. The model has then been applied to simulate the effect of different screening algorithms with ULTRIO and the new-generation ULTRIO Plus assay (Novartis Diagnostics) on transmission risk for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). We calculated WP risk-day equivalents for MP16-, MP8-, and ID-NAT with and without duplicate retesting of IR results of 3.1, 2.7, 1.5, and 1.3 days for HCV; 6.3, 5.5, 3.3, and 2.9 days for HIV; and 24.4, 22.2, 15.6, and 14.1 days for HBV, respectively. These latter infectious HBV WPs reduced to 20.4, 18.2, 11.6, and 10.3 days, respectively, with the more sensitive ULTRIO Plus assay. ULTRIO Plus ID-NAT screening reduces the virus transmission risk in the WP by 54% to 58% compared to ULTRIO MP16-NAT, while the incremental risk caused by releasing donations with duplicate ID-NAT NRR results is 5% to 6%. To achieve maximum safety and specificity a similar repeat test algorithm can be applied to ID-NAT as used for serologic assays.Keywords
This publication has 21 references indexed in Scilit:
- Impact of individual-donation nucleic acid testing on risk of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus transmission by blood transfusion in South AfricaTransfusion, 2009
- High Specific Infectivity of Plasma Virus from the Pre-Ramp-Up and Ramp-Up Stages of Acute Simian Immunodeficiency Virus InfectionJournal of Virology, 2009
- Comparison of the analytical and operational performance of two viral nucleic acid test blood screening systems: Procleix Tigris and cobas s 201Transfusion, 2009
- Minimum infectious dose of hepatitis B virus in chimpanzees and difference in the dynamics of viremia between genotype A and genotype CTransfusion, 2007
- Dynamics of viremia in early hepatitis C virus infectionTransfusion, 2005
- A new strategy for estimating risks of transfusion‐transmitted viral infections based on rates of detection of recently infected donorsTransfusion, 2005
- Titration of Hepatitis C Virus in Chimpanzees for Determining the Copy Number Required for TransmissionIntervirology, 2004
- Dynamics of HIV viremia and antibody seroconversion in plasma donorsAIDS, 2003
- Comparative sensitivity of HBV NATs and HBsAg assays for detection of acute HBV infectionTransfusion, 2003
- Mathematic modeling of the risk of HBV, HCV, and HIV transmission by window‐phase donations not detected by NATTransfusion, 2002