Asian Journal of Transfusion Science
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LETTER TO THE EDITOR Table of Contents   
Year : 2017  |  Volume : 11  |  Issue : 1  |  Page : 72-73
Chemiluminescence brings renaissance in TTI screening: Primi experientia


Department of Transfusion Medicine, AIIMS, New Delhi, India

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Date of Web Publication22-Feb-2017
 

How to cite this article:
Rout D, Chaurasia R, Coshic P, Chatterjee K. Chemiluminescence brings renaissance in TTI screening: Primi experientia. Asian J Transfus Sci 2017;11:72-3

How to cite this URL:
Rout D, Chaurasia R, Coshic P, Chatterjee K. Chemiluminescence brings renaissance in TTI screening: Primi experientia. Asian J Transfus Sci [serial online] 2017 [cited 2017 Mar 25];11:72-3. Available from: http://www.ajts.org/text.asp?2017/11/1/72/200777


Sir,

India with a population of 1.26 billion has seroprevalence rates ranging from 0.2–1%, 0.4–1.09%, and 1.8–4% for HIV, hepatitis C virus (HCV), and hepatitis B virus (HBV), respectively, in the blood donors population.[1],[2],[3],[4] Majority of the blood banks in India are using ELISA-based serologic screening for transfusion-transmissible viral infections (TTIs). The automated platform for chemiluminescence (ACLS) has been introduced in the recent past, as a newer serological screening tool that offers good precision, reliability, and high throughput.[5] Although ACLS appears to be an effective replacement for ELISA, the paucity of published research works in support of ACLS, makes this a mere assumption only. Performance evaluation and feasibility assessment of ACLS for routine TTI screening were done at our center based on its concordance with that of ELISA and nucleic acid test (NAT).

Routine TTI screening of all the blood units collected from 1st to 30th September 2015, was done simultaneously by ELISA (DaVinci, Biomérieux, France) for anti-HIV (4th generation kits), anti-HCV (3rd generation kits), and hepatitis B surface antigen (HBsAg) (3rd generation kits); ACLS (Architect i1000 SR, Abbott, USA) for anti-HIV (4th generation kits), anti-HCV (3rd generation kits), and HBsAg (3rd generation kits); and NAT (Procleix Ultrio, Grifols, Hong Kong) for HIV-RNA, HCV-RNA, and HBV-DNA. All the NAT nonreactive units with discordant serology results were subjected to viral load quantification by real-time polymerase chain reaction (RT-PCR) (Cobas TaqMan, Roche, USA) for confirming the infectious status.

Overall, 2.33% (75 of 3213) units were found to be TTI reactive by ≥1 method. Thirty-four (1.05%) units were found to be concordant reactive by all 3 methods, whereas 41 (1.27%) units were reported to have discordant results. Of these 41 discordant units, 29 (70.7%) units were serology only reactive (9 ELISA only, 15 ACLS only, and 5 by both) and 12 (29.3%) units were NAT-reactive irrespective of their serological results [Table 1]. Repeat serological tests for these 29 samples gave consistent results with that of earlier tests though neither NAT nor the RT-PCR could detect the infectious viral markers. However, these donors were kept under follow-up category to ascertain their infectious status as seroyields. Taking NAT as gold standard, the relative sensitivity and specificity of ELISA were 80.43% and 99.55%, respectively, and those of ACLS were 76.08% and 99.36%, respectively. The observed discrepancies among the 3 methods used, may be due to the different principles of the serological and molecular techniques or of chance occurrence due to the smaller study population. Our preliminary result with ACLS warrants a further study with a larger donor population for confirmation.
Table 1: Details of transmissible viral infection reactivity by different testing techniques

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The shorter turn-around time and option for STAT tests give ACLS a definite edge over ELISA, especially during the preprocedural TTI screening for apheresis donors. Therefore, with comparable detection rates and faster turnaround time, ACLS appears as an acceptable alternative for ELISA when used with NAT.

Acknowledgment

The authors are thankful to Mr. Raj Kumar and Mrs. Seema Yadav for their technical support.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Meena M, Jindal T, Hazarika A. Prevalence of hepatitis B virus and hepatitis C virus among blood donors at a tertiary care hospital in India: A five-year study. Transfusion 2011;51:198-202.  Back to cited text no. 1
    
2.
Pallavi P, Ganesh CK, Jayashree K, Manjunath GV. Seroprevalence and trends in transfusion transmitted infections among blood donors in a university hospital blood bank: A 5 year study. Indian J Hematol Blood Transfus 2011;27:1-6.  Back to cited text no. 2
    
3.
Chatterjee K, Coshic P, Borgohain M, Premchand, Thapliyal RM, Chakroborty S, et al. Individual donor nucleic acid testing for blood safety against HIV-1 and hepatitis B and C viruses in a tertiary care hospital. Natl Med J India 2012;25:207-9.  Back to cited text no. 3
    
4.
Chaurasia R, Zaman S, Das B, Chatterjee K. Screening Donated Blood for Transfusion Transmitted Infections by Serology along with NAT and Response Rate to Notification of Reactive Results: An Indian Experience. J Blood Transfus 2014;2014:412105. doi: 10.1155/2014/412105.  Back to cited text no. 4
    
5.
Kim S, Kim JH, Yoon S, Park YH, Kim HS. Clinical performance evaluation of four automated chemiluminescence immunoassays for hepatitis C virus antibody detection. J Clin Microbiol 2008;46:3919-23.  Back to cited text no. 5
    

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Correspondence Address:
Diptiranjan Rout
Department of Transfusion Medicine, AIIMS, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-6247.200777

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2006 - Asian Journal of Transfusion Science | Published by Wolters Kluwer - Medknow
Online since 10th November, 2006