الفهرس 
Transfusion Transmitted Infections (TTIs)Only 14 pages are availabe for public view
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Abstract
The safety of blood products is one of the major issues in the area of transfusion medicine. Screening of blood donors for transmissible agents play a major role to decrease the risk of transfusion of infected units. Firstly, testing of antibody/or antigen markers of blood borne pathogens was established. However, limitation of these serological techniques including window period between infection time and detection time, and antigenic variability enhance implementation of NAT.
NAT is a highly sensitive and advanced molecular technique. It is based on amplification of target regions of viral RNA or DNA and detects them earlier than other screening methods which thus reducing the window period for HBV, HCV and HIV to 8, 7 and 9 days respectively. NAT blood screening system was originally intended to complement serological screening for detection of donations infectious for those viruses.
This study was conducted at ARBTC, blood donation collected from 10000 voluntary donors from January 2016 to June 2016 and tested with both ID NAT and ELISA assays for HBV, HCV and HIV. Using the PROCLEIX® TIGRIS® System, ID-NAT depending on (TMA) Technology. TMA assay involves three main steps utilizing three proprietary technologies:
(a) Target capture based sample preparation,
(b) Transcription-mediated amplification,
(c) Hybridization protection assay.
Data collected and analysis done for serological and NAT results to detect seronegative, reactive NAT yield and residual risk of TTIs.
The current study identified 7 samples (0. 07%) as NAT yield (seronegative samples and NAT reactive) of total 10000 tested samples. The NAT yield of 7 samples in 10000 samples assumes more significance when one considers the fact that single donation is used for generating 3 components (packed RBCs, plasma, platelet) that can be used by 3 recipients.
In this study, the prevalence of transfusion transmitted viruses among the studied donors were 4.6% for HCV and 1.56% for HBV, total number of false positive tested samples with were 123 samples (1.2%) of total tested samples.
The need for NAT depends on the prevalence and incidence rate of infections in blood donor population, available resources and the evidence of benefit added when combined with serology tests. Hence the decision of starting NAT should be considered when basic quality assured blood transfusion system is already in place such as volunteer base for blood donation, provision of donor self-deferral, donor notification and counseling along with quality assured sensitive serological methods for testing TTIs.
In the present study blood group O was commonest followed by A and B; AB was the least common. Regarding Rh factor, Rh positive blood group system was 80% much greater than Rh negative blood group system 20% in the current study.
In this study observed that HCV and HBV were found to be higher in donors who has blood group O (43.3%, 44%) respectively and lowest in donors who has blood group AB (6.7%, 3.2%) respectively, There was a significant association between the blood group of the patient who infected with HBV and healthy blood donors and there was a highly significant association among the blood group of the patient who infected with HCV and healthy blood donors, positive Rh system was more common among people with hepatitis infection than people without infection, but there was a highly percentage variation between Rh positive and Rh negative groups.
With the help of scientific evidence it can be correlated that the level of natural antibodies resistance against the viral antigens depends on the individual’s blood group. Further studies aimed at determining the epidemiology of these infections among the general population will be of value in determining the safety of blood /blood components.
Finally, NAT could detect HIV, HBV, and HCV cases in blood donor samples those were undetected by serological tests (reduce the window period) and save donations from being wasted due to their false reactivity by ELISA testing.
Seroprevalence of HBs Ag and HCV Ab were found to be higher in donors who has blood group O and lowest in blood group AB donors. While the distribution of Rh in hepatitis infections was higher between Rh positive donors.