HIV antibody screening remains indispensable for ensuring viral safety of blood components despite NAT implementation

Authors

  • Syria Laperche,

    1. From the Study Unit of Blood-Borne Agents and National Reference Center on Post-transfusion Hepatitis, National Institute of Blood Transfusion, Paris, France; the French Blood Center, Bourgogne-Franche-Comte, Dijon, France; and the Laboratory of Hematology, University Medical Center, Amiens, France.
    Search for more papers by this author
  • Pascal Morel,

    1. From the Study Unit of Blood-Borne Agents and National Reference Center on Post-transfusion Hepatitis, National Institute of Blood Transfusion, Paris, France; the French Blood Center, Bourgogne-Franche-Comte, Dijon, France; and the Laboratory of Hematology, University Medical Center, Amiens, France.
    Search for more papers by this author
  • Marie Deschaseaux,

    1. From the Study Unit of Blood-Borne Agents and National Reference Center on Post-transfusion Hepatitis, National Institute of Blood Transfusion, Paris, France; the French Blood Center, Bourgogne-Franche-Comte, Dijon, France; and the Laboratory of Hematology, University Medical Center, Amiens, France.
    Search for more papers by this author
  • Françoise Bouchardeau,

    1. From the Study Unit of Blood-Borne Agents and National Reference Center on Post-transfusion Hepatitis, National Institute of Blood Transfusion, Paris, France; the French Blood Center, Bourgogne-Franche-Comte, Dijon, France; and the Laboratory of Hematology, University Medical Center, Amiens, France.
    Search for more papers by this author
  • Gulie Alimardani,

    1. From the Study Unit of Blood-Borne Agents and National Reference Center on Post-transfusion Hepatitis, National Institute of Blood Transfusion, Paris, France; the French Blood Center, Bourgogne-Franche-Comte, Dijon, France; and the Laboratory of Hematology, University Medical Center, Amiens, France.
    Search for more papers by this author
  • Nicolas Guillaume,

    1. From the Study Unit of Blood-Borne Agents and National Reference Center on Post-transfusion Hepatitis, National Institute of Blood Transfusion, Paris, France; the French Blood Center, Bourgogne-Franche-Comte, Dijon, France; and the Laboratory of Hematology, University Medical Center, Amiens, France.
    Search for more papers by this author
  • Philippe Rouger,

    1. From the Study Unit of Blood-Borne Agents and National Reference Center on Post-transfusion Hepatitis, National Institute of Blood Transfusion, Paris, France; the French Blood Center, Bourgogne-Franche-Comte, Dijon, France; and the Laboratory of Hematology, University Medical Center, Amiens, France.
    Search for more papers by this author
  • Jean-Jacques Lefrère

    Corresponding author
    1. From the Study Unit of Blood-Borne Agents and National Reference Center on Post-transfusion Hepatitis, National Institute of Blood Transfusion, Paris, France; the French Blood Center, Bourgogne-Franche-Comte, Dijon, France; and the Laboratory of Hematology, University Medical Center, Amiens, France.
    Search for more papers by this author

Jean-Jacques Lefrère, INTS, 6 rue Alexandre-Cabanel, 75015 Paris, France; e-mail: jjlefrere@ints.fr.

Abstract

BACKGROUND:  The main objective of the imple-mentation of NAT for the screening of blood-borne viruses was to compensate for the failure of serologic assays during the window period. Because this new screening procedure theoretically covers the entire period of infectivity, the necessity for maintaining serologic assays in blood screening strategy could become questionable.

STUDY DESIGN AND METHODS:  To investigate this issue, a panel of 35 samples has been studied by NAT. These samples had been collected from HIV-1 antibody-positive individuals presenting a persistently low viral RNA load (<400 copies/mL) in the absence of antiviral therapy. All samples were analyzed with the minipool (×8) NAT routinely used in blood bank setting (HIV-1 and HCV assay based on transcription-mediated amplification) and with single-donation testing.

RESULTS:  The minipool NAT failed to detect the presence of HIV RNA in 15 of the 35 samples (11 remained negative when retested). Single-donation testing gave negative results in 4 samples (3 remained negative when retested). Fourteen of the 18 samples with a viral load greater than 50 copies per mL were positive by minipool NAT versus 6 of the 17 samples with fewer than 50 copies per mL (p = 0.02).

CONCLUSION:  The results clearly demonstrate that anti-HIV screening should not be withdrawn from biologic qualification procedures of blood donations, even when single NAT is performed.

Ancillary