Daniel Candotti1, Virginie Sauvage1, Pierre Cappy1, Mohamed Abdallahi Boullahi2, Pascal Bizimana3, Guy Olivier Mbensa4, Sekou Oumar Coulibaly5, Aimée Olivat Rakoto Alson6, Hadiza Soumana7, Claude Tagny-Tayou8, Edward L Murphy9,10, Syria Laperche1. 1. National Institute of Blood Transfusion/INTS, National Reference Center for Infectious Risk in Transfusion, Department of Blood-borne Agents, Paris, France. 2. National Blood Center, Nouakchott, Mauritania. 3. National Blood Center, Bujumbura, Burundi. 4. National Blood Center, Kinshasa, Democratic Republic of the Congo. 5. National Blood Center, Bamako, Mali. 6. National Blood Center, Antananarivo, Madagascar. 7. National Blood Center, Niamey, Niger. 8. Department of Hematology, Faculty of Medicine and Biomedical Sciences of University of Yaoundé I, Yaoundé, Cameroon. 9. Departments of Laboratory Medicine and Epidemiology/Biostatistics, University of California, San Francisco, San Francisco, California. 10. Vitalant Research Institute, San Francisco, California.
Abstract
BACKGROUND: False positivity in blood screening may cause unnecessary deferral of healthy donors and exacerbate blood shortages. An international multicenter study was conducted to estimate the frequency of HCV and HIV false seropositivity in seven African countries (Burundi, Cameroon, Democratic Republic of Congo, Madagascar, Mali, Mauritania, and Niger). STUDY DESIGN AND METHODS: Blood donations were tested for hepatitis C virus (HCV) and human immunodeficiency virus (HIV) with rapid detection tests (RDTs), third-generation enzyme immunoassays (EIAs), or fourth-generation EIAs. HCV (456/16,613 [2.74%]) and HIV (249/16,675 [1.49%]) reactive samples were then confirmed with antigen/antibody assays, immunoblots, and nucleic acid testing. Partial viral sequences were analyzed when possible. RESULTS: The HCV reactivity rate with RDTs was significantly lower than with EIAs (0.55% vs. 3.52%; p < 0.0001). The HIV reactivity rate with RDTs was lower than with third-generation EIAs (1.02% vs. 2.38%; p < 0.0001) but similar to a fourth-generation assay (1.09%). Only 16.0% (57/357) and 21.5% (38/177) of HCV and HIV initial reactive samples, respectively, were repeatedly reactive. HCV and HIV infections were confirmed in 13.2% and 13.7%, respectively, of repeated reactive donations. The predominant HCV genotype 2 and 4 strains in West and Central Africa showed high genetic variability. HIV-1 subtype CRF02_AG was most prevalent. CONCLUSION: High rates (>80%) of unconfirmed anti-HCV and anti-HIV reactivity observed in several sub-Saharan countries highlights the need for better testing and confirmatory strategies for donors screening in Africa. Without confirmatory testing, HCV and HIV prevalence in African blood donors has probably been overestimated.
BACKGROUND: False positivity in blood screening may cause unnecessary deferral of healthy donors and exacerbate blood shortages. An international multicenter study was conducted to estimate the frequency of HCV and HIV false seropositivity in seven African countries (Burundi, Cameroon, Democratic Republic of Congo, Madagascar, Mali, Mauritania, and Niger). STUDY DESIGN AND METHODS: Blood donations were tested for hepatitis C virus (HCV) and human immunodeficiency virus (HIV) with rapid detection tests (RDTs), third-generation enzyme immunoassays (EIAs), or fourth-generation EIAs. HCV (456/16,613 [2.74%]) and HIV (249/16,675 [1.49%]) reactive samples were then confirmed with antigen/antibody assays, immunoblots, and nucleic acid testing. Partial viral sequences were analyzed when possible. RESULTS: The HCV reactivity rate with RDTs was significantly lower than with EIAs (0.55% vs. 3.52%; p < 0.0001). The HIV reactivity rate with RDTs was lower than with third-generation EIAs (1.02% vs. 2.38%; p < 0.0001) but similar to a fourth-generation assay (1.09%). Only 16.0% (57/357) and 21.5% (38/177) of HCV and HIV initial reactive samples, respectively, were repeatedly reactive. HCV and HIV infections were confirmed in 13.2% and 13.7%, respectively, of repeated reactive donations. The predominant HCV genotype 2 and 4 strains in West and Central Africa showed high genetic variability. HIV-1 subtype CRF02_AG was most prevalent. CONCLUSION: High rates (>80%) of unconfirmed anti-HCV and anti-HIV reactivity observed in several sub-Saharan countries highlights the need for better testing and confirmatory strategies for donors screening in Africa. Without confirmatory testing, HCV and HIV prevalence in African blood donors has probably been overestimated.
Authors: Claude T Tagny; Georges Ikomey; Françoise Ngo Sack; Celestin Achu; Matthias Ndemanou; Catherine Ninmou; Caroline Gesu; Gilbert Essomba; Alexandra Fongue Simo; Georges Nguefack Tsague; Dora Mbanya; Edward Murphy Journal: Vox Sang Date: 2022-03-17 Impact factor: 2.996
Authors: Marion C Lanteri; Felicia Santa-Maria; Andrew Laughhunn; Yvette A Girard; Marcus Picard-Maureau; Jean-Marc Payrat; Johannes Irsch; Adonis Stassinopoulos; Peter Bringmann Journal: Transfusion Date: 2020-04-24 Impact factor: 3.157