Efficacy of individual nucleic acid amplification testing in reducing the risk of transfusion-transmitted hepatitis B virus infection in Switzerland, a low-endemic region
Martin Stolz
From the Blood Transfusion Service SRC Berne, Berne, Switzerland; the Blood Transfusion Service SRC Basel, Basel, Switzerland; the Blood Transfusion Service SRC Geneva, Geneva, Switzerland; the Blood Transfusion Service SRC Vaud, Lausanne, Switzerland; the Blood Transfusion Service SRC North East Switzerland, Münsterlingen, Switzerland; the Blood Transfusion Service Solothurn, Solothurn, Switzerland; and Novartis Diagnostics, Suresnes, France.
Search for more papers by this authorCaroline Tinguely
From the Blood Transfusion Service SRC Berne, Berne, Switzerland; the Blood Transfusion Service SRC Basel, Basel, Switzerland; the Blood Transfusion Service SRC Geneva, Geneva, Switzerland; the Blood Transfusion Service SRC Vaud, Lausanne, Switzerland; the Blood Transfusion Service SRC North East Switzerland, Münsterlingen, Switzerland; the Blood Transfusion Service Solothurn, Solothurn, Switzerland; and Novartis Diagnostics, Suresnes, France.
Search for more papers by this authorMauro Graziani
From the Blood Transfusion Service SRC Berne, Berne, Switzerland; the Blood Transfusion Service SRC Basel, Basel, Switzerland; the Blood Transfusion Service SRC Geneva, Geneva, Switzerland; the Blood Transfusion Service SRC Vaud, Lausanne, Switzerland; the Blood Transfusion Service SRC North East Switzerland, Münsterlingen, Switzerland; the Blood Transfusion Service Solothurn, Solothurn, Switzerland; and Novartis Diagnostics, Suresnes, France.
Search for more papers by this authorStefano Fontana
From the Blood Transfusion Service SRC Berne, Berne, Switzerland; the Blood Transfusion Service SRC Basel, Basel, Switzerland; the Blood Transfusion Service SRC Geneva, Geneva, Switzerland; the Blood Transfusion Service SRC Vaud, Lausanne, Switzerland; the Blood Transfusion Service SRC North East Switzerland, Münsterlingen, Switzerland; the Blood Transfusion Service Solothurn, Solothurn, Switzerland; and Novartis Diagnostics, Suresnes, France.
Search for more papers by this authorPeter Gowland
From the Blood Transfusion Service SRC Berne, Berne, Switzerland; the Blood Transfusion Service SRC Basel, Basel, Switzerland; the Blood Transfusion Service SRC Geneva, Geneva, Switzerland; the Blood Transfusion Service SRC Vaud, Lausanne, Switzerland; the Blood Transfusion Service SRC North East Switzerland, Münsterlingen, Switzerland; the Blood Transfusion Service Solothurn, Solothurn, Switzerland; and Novartis Diagnostics, Suresnes, France.
Search for more papers by this authorAndreas Buser
From the Blood Transfusion Service SRC Berne, Berne, Switzerland; the Blood Transfusion Service SRC Basel, Basel, Switzerland; the Blood Transfusion Service SRC Geneva, Geneva, Switzerland; the Blood Transfusion Service SRC Vaud, Lausanne, Switzerland; the Blood Transfusion Service SRC North East Switzerland, Münsterlingen, Switzerland; the Blood Transfusion Service Solothurn, Solothurn, Switzerland; and Novartis Diagnostics, Suresnes, France.
Search for more papers by this authorMartine Michel
From the Blood Transfusion Service SRC Berne, Berne, Switzerland; the Blood Transfusion Service SRC Basel, Basel, Switzerland; the Blood Transfusion Service SRC Geneva, Geneva, Switzerland; the Blood Transfusion Service SRC Vaud, Lausanne, Switzerland; the Blood Transfusion Service SRC North East Switzerland, Münsterlingen, Switzerland; the Blood Transfusion Service Solothurn, Solothurn, Switzerland; and Novartis Diagnostics, Suresnes, France.
Search for more papers by this authorGiorgia Canellini
From the Blood Transfusion Service SRC Berne, Berne, Switzerland; the Blood Transfusion Service SRC Basel, Basel, Switzerland; the Blood Transfusion Service SRC Geneva, Geneva, Switzerland; the Blood Transfusion Service SRC Vaud, Lausanne, Switzerland; the Blood Transfusion Service SRC North East Switzerland, Münsterlingen, Switzerland; the Blood Transfusion Service Solothurn, Solothurn, Switzerland; and Novartis Diagnostics, Suresnes, France.
Search for more papers by this authorMax Züger
From the Blood Transfusion Service SRC Berne, Berne, Switzerland; the Blood Transfusion Service SRC Basel, Basel, Switzerland; the Blood Transfusion Service SRC Geneva, Geneva, Switzerland; the Blood Transfusion Service SRC Vaud, Lausanne, Switzerland; the Blood Transfusion Service SRC North East Switzerland, Münsterlingen, Switzerland; the Blood Transfusion Service Solothurn, Solothurn, Switzerland; and Novartis Diagnostics, Suresnes, France.
Search for more papers by this authorPhilippe Schumacher
From the Blood Transfusion Service SRC Berne, Berne, Switzerland; the Blood Transfusion Service SRC Basel, Basel, Switzerland; the Blood Transfusion Service SRC Geneva, Geneva, Switzerland; the Blood Transfusion Service SRC Vaud, Lausanne, Switzerland; the Blood Transfusion Service SRC North East Switzerland, Münsterlingen, Switzerland; the Blood Transfusion Service Solothurn, Solothurn, Switzerland; and Novartis Diagnostics, Suresnes, France.
Search for more papers by this authorNico Lelie
From the Blood Transfusion Service SRC Berne, Berne, Switzerland; the Blood Transfusion Service SRC Basel, Basel, Switzerland; the Blood Transfusion Service SRC Geneva, Geneva, Switzerland; the Blood Transfusion Service SRC Vaud, Lausanne, Switzerland; the Blood Transfusion Service SRC North East Switzerland, Münsterlingen, Switzerland; the Blood Transfusion Service Solothurn, Solothurn, Switzerland; and Novartis Diagnostics, Suresnes, France.
Search for more papers by this authorChristoph Niederhauser
From the Blood Transfusion Service SRC Berne, Berne, Switzerland; the Blood Transfusion Service SRC Basel, Basel, Switzerland; the Blood Transfusion Service SRC Geneva, Geneva, Switzerland; the Blood Transfusion Service SRC Vaud, Lausanne, Switzerland; the Blood Transfusion Service SRC North East Switzerland, Münsterlingen, Switzerland; the Blood Transfusion Service Solothurn, Solothurn, Switzerland; and Novartis Diagnostics, Suresnes, France.
Search for more papers by this authorMartin Stolz
From the Blood Transfusion Service SRC Berne, Berne, Switzerland; the Blood Transfusion Service SRC Basel, Basel, Switzerland; the Blood Transfusion Service SRC Geneva, Geneva, Switzerland; the Blood Transfusion Service SRC Vaud, Lausanne, Switzerland; the Blood Transfusion Service SRC North East Switzerland, Münsterlingen, Switzerland; the Blood Transfusion Service Solothurn, Solothurn, Switzerland; and Novartis Diagnostics, Suresnes, France.
Search for more papers by this authorCaroline Tinguely
From the Blood Transfusion Service SRC Berne, Berne, Switzerland; the Blood Transfusion Service SRC Basel, Basel, Switzerland; the Blood Transfusion Service SRC Geneva, Geneva, Switzerland; the Blood Transfusion Service SRC Vaud, Lausanne, Switzerland; the Blood Transfusion Service SRC North East Switzerland, Münsterlingen, Switzerland; the Blood Transfusion Service Solothurn, Solothurn, Switzerland; and Novartis Diagnostics, Suresnes, France.
Search for more papers by this authorMauro Graziani
From the Blood Transfusion Service SRC Berne, Berne, Switzerland; the Blood Transfusion Service SRC Basel, Basel, Switzerland; the Blood Transfusion Service SRC Geneva, Geneva, Switzerland; the Blood Transfusion Service SRC Vaud, Lausanne, Switzerland; the Blood Transfusion Service SRC North East Switzerland, Münsterlingen, Switzerland; the Blood Transfusion Service Solothurn, Solothurn, Switzerland; and Novartis Diagnostics, Suresnes, France.
Search for more papers by this authorStefano Fontana
From the Blood Transfusion Service SRC Berne, Berne, Switzerland; the Blood Transfusion Service SRC Basel, Basel, Switzerland; the Blood Transfusion Service SRC Geneva, Geneva, Switzerland; the Blood Transfusion Service SRC Vaud, Lausanne, Switzerland; the Blood Transfusion Service SRC North East Switzerland, Münsterlingen, Switzerland; the Blood Transfusion Service Solothurn, Solothurn, Switzerland; and Novartis Diagnostics, Suresnes, France.
Search for more papers by this authorPeter Gowland
From the Blood Transfusion Service SRC Berne, Berne, Switzerland; the Blood Transfusion Service SRC Basel, Basel, Switzerland; the Blood Transfusion Service SRC Geneva, Geneva, Switzerland; the Blood Transfusion Service SRC Vaud, Lausanne, Switzerland; the Blood Transfusion Service SRC North East Switzerland, Münsterlingen, Switzerland; the Blood Transfusion Service Solothurn, Solothurn, Switzerland; and Novartis Diagnostics, Suresnes, France.
Search for more papers by this authorAndreas Buser
From the Blood Transfusion Service SRC Berne, Berne, Switzerland; the Blood Transfusion Service SRC Basel, Basel, Switzerland; the Blood Transfusion Service SRC Geneva, Geneva, Switzerland; the Blood Transfusion Service SRC Vaud, Lausanne, Switzerland; the Blood Transfusion Service SRC North East Switzerland, Münsterlingen, Switzerland; the Blood Transfusion Service Solothurn, Solothurn, Switzerland; and Novartis Diagnostics, Suresnes, France.
Search for more papers by this authorMartine Michel
From the Blood Transfusion Service SRC Berne, Berne, Switzerland; the Blood Transfusion Service SRC Basel, Basel, Switzerland; the Blood Transfusion Service SRC Geneva, Geneva, Switzerland; the Blood Transfusion Service SRC Vaud, Lausanne, Switzerland; the Blood Transfusion Service SRC North East Switzerland, Münsterlingen, Switzerland; the Blood Transfusion Service Solothurn, Solothurn, Switzerland; and Novartis Diagnostics, Suresnes, France.
Search for more papers by this authorGiorgia Canellini
From the Blood Transfusion Service SRC Berne, Berne, Switzerland; the Blood Transfusion Service SRC Basel, Basel, Switzerland; the Blood Transfusion Service SRC Geneva, Geneva, Switzerland; the Blood Transfusion Service SRC Vaud, Lausanne, Switzerland; the Blood Transfusion Service SRC North East Switzerland, Münsterlingen, Switzerland; the Blood Transfusion Service Solothurn, Solothurn, Switzerland; and Novartis Diagnostics, Suresnes, France.
Search for more papers by this authorMax Züger
From the Blood Transfusion Service SRC Berne, Berne, Switzerland; the Blood Transfusion Service SRC Basel, Basel, Switzerland; the Blood Transfusion Service SRC Geneva, Geneva, Switzerland; the Blood Transfusion Service SRC Vaud, Lausanne, Switzerland; the Blood Transfusion Service SRC North East Switzerland, Münsterlingen, Switzerland; the Blood Transfusion Service Solothurn, Solothurn, Switzerland; and Novartis Diagnostics, Suresnes, France.
Search for more papers by this authorPhilippe Schumacher
From the Blood Transfusion Service SRC Berne, Berne, Switzerland; the Blood Transfusion Service SRC Basel, Basel, Switzerland; the Blood Transfusion Service SRC Geneva, Geneva, Switzerland; the Blood Transfusion Service SRC Vaud, Lausanne, Switzerland; the Blood Transfusion Service SRC North East Switzerland, Münsterlingen, Switzerland; the Blood Transfusion Service Solothurn, Solothurn, Switzerland; and Novartis Diagnostics, Suresnes, France.
Search for more papers by this authorNico Lelie
From the Blood Transfusion Service SRC Berne, Berne, Switzerland; the Blood Transfusion Service SRC Basel, Basel, Switzerland; the Blood Transfusion Service SRC Geneva, Geneva, Switzerland; the Blood Transfusion Service SRC Vaud, Lausanne, Switzerland; the Blood Transfusion Service SRC North East Switzerland, Münsterlingen, Switzerland; the Blood Transfusion Service Solothurn, Solothurn, Switzerland; and Novartis Diagnostics, Suresnes, France.
Search for more papers by this authorChristoph Niederhauser
From the Blood Transfusion Service SRC Berne, Berne, Switzerland; the Blood Transfusion Service SRC Basel, Basel, Switzerland; the Blood Transfusion Service SRC Geneva, Geneva, Switzerland; the Blood Transfusion Service SRC Vaud, Lausanne, Switzerland; the Blood Transfusion Service SRC North East Switzerland, Münsterlingen, Switzerland; the Blood Transfusion Service Solothurn, Solothurn, Switzerland; and Novartis Diagnostics, Suresnes, France.
Search for more papers by this authorAbstract
BACKGROUND: The risk of transfusion-transmitted hepatitis B virus (HBV) in Switzerland by testing blood donors for hepatitis B surface antigen (HBsAg) alone has been historically estimated at 1:160,000 transfusions. The Swiss health authorities decided not to introduce mandatory antibody to hepatitis B core antigen (anti-HBc) testing but to evaluate the investigation of HBV nucleic acid testing (NAT).
STUDY DESIGN AND METHODS: Between June 2007 and February 2009, a total of 306,000 donations were screened routinely for HBsAg and HBV DNA by triplex individual-donation (ID)-NAT (Ultrio assay on Tigris system, Gen-Probe/Novartis Diagnostics). ID-NAT repeatedly reactive donors were further characterized for HBV serologic markers and viral load by quantitative polymerase chain reaction. The relative sensitivity of screening for HBsAg, anti-HBc, and HBV DNA was assessed. The residual HBV transmission risk of NAT with or without anti-HBc and HBsAg was retrospectively estimated in a mathematical model.
RESULTS: From the 306,000 blood donations, 31 were repeatedly Ultrio test reactive and confirmed HBV infected, of which 24 (77%) and 27 (87%) were HBsAg and anti-HBc positive, respectively. Seven HBV-NAT yields were identified (1:44,000), two pre-HBsAg window period (WP) donations (1:153,000) and five occult HBV infections (1:61,000). Introduction of ID-NAT reduced the risk of HBV WP transmission in repeat donors from 1:95,000 to 1:296,000.
CONCLUSIONS: Triplex NAT screening reduced the HBV WP transmission risk approximately threefold. NAT alone was more efficacious than the combined use of HBsAg and anti-HBc. The data from this study led to the decision to introduce sensitive HBV-NAT screening in Switzerland. Our findings may be useful in designing more efficient and cost-effective HBV screening strategies in low-prevalence countries.
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