Will genome detection replace serology in blood screening for microbial agents?

被引:18
作者
Allain, JP [1 ]
机构
[1] Univ Cambridge, Dept Haematol, Div Transfus Med, Cambridge, England
关键词
screening; viral genome; NAT; HBV; HIV; HCV;
D O I
10.1053/beha.2000.0103
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The residual risk of transfusion-transmitted viral infection in developed countries is considered minimal or negligible. However, zero risk remains a strong political objective. Genomic screening for HCV, HIV and HBV represents a major advance, eliminating infectious blood donations collected during the pre-seroconversion window period, rare cases of immunosilent infections and, possibly, a large spectrum of viral variants. In Western countries, HCV RNA genomic screening started on pools of 16-400 plasma samples from individual donations. Pooling may produce false-positive and false-negative results. Individual donation testing is more suitable to blood screening but requires multiplexing, automation, and affordable cost. Because donations from individuals who are HBV DNA-negative/serologically positive, or those apparently recovered from HCV infection, may remain infectious, it is unlikely that HBsAg, anti-HCV, and anti-HIV will be discontinued when genomic screening is extended to all three viruses. HIV-I p24 antigen may prove redundant with HIV RNA screening. Anti-HTLV-l and HTLV-II will remain more effective than genomic testing.
引用
收藏
页码:615 / 629
页数:15
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