High rate of hepatitis C virus and human immunodeficiency virus false-positive results in serologic screening in sub-Saharan Africa: adverse impact on the blood supply
Corresponding Author
Daniel Candotti
National Institute of Blood Transfusion/INTS, National Reference Center for Infectious Risk in Transfusion, Department of Blood-borne Agents, Paris, France
Address reprint requests to: Syria Laperche, Institut National de la Transfusion Sanguine, 6 rue Alexandre Cabanel, 75015 Paris, France; e-mail: [email protected]; or Daniel Candotti, Institut National de la Transfusion Sanguine, 6 rue Alexandre Cabanel, 75015 Paris, France; e-mail: [email protected].Search for more papers by this authorVirginie Sauvage
National Institute of Blood Transfusion/INTS, National Reference Center for Infectious Risk in Transfusion, Department of Blood-borne Agents, Paris, France
VS and PC contributed equally to this work.Search for more papers by this authorPierre Cappy
National Institute of Blood Transfusion/INTS, National Reference Center for Infectious Risk in Transfusion, Department of Blood-borne Agents, Paris, France
VS and PC contributed equally to this work.Search for more papers by this authorMohamed Abdallahi Boullahi
National Blood Center, Nouakchott, Mauritania
Search for more papers by this authorGuy Olivier Mbensa
National Blood Center, Kinshasa, Democratic Republic of the Congo
Search for more papers by this authorAimée Olivat Rakoto Alson
National Blood Center, Antananarivo, Madagascar
Search for more papers by this authorClaude Tagny-Tayou
Department of Hematology, Faculty of Medicine and Biomedical Sciences of University of Yaoundé I, Yaoundé, Cameroon
Search for more papers by this authorEdward L. Murphy
Departments of Laboratory Medicine and Epidemiology/Biostatistics, University of California, San Francisco, San Francisco, California
Vitalant Research Institute, San Francisco, California
Search for more papers by this authorCorresponding Author
Syria Laperche
National Institute of Blood Transfusion/INTS, National Reference Center for Infectious Risk in Transfusion, Department of Blood-borne Agents, Paris, France
Address reprint requests to: Syria Laperche, Institut National de la Transfusion Sanguine, 6 rue Alexandre Cabanel, 75015 Paris, France; e-mail: [email protected]; or Daniel Candotti, Institut National de la Transfusion Sanguine, 6 rue Alexandre Cabanel, 75015 Paris, France; e-mail: [email protected].Search for more papers by this authorfor The Francophone Africa Transfusion Research Network
Search for more papers by this authorCorresponding Author
Daniel Candotti
National Institute of Blood Transfusion/INTS, National Reference Center for Infectious Risk in Transfusion, Department of Blood-borne Agents, Paris, France
Address reprint requests to: Syria Laperche, Institut National de la Transfusion Sanguine, 6 rue Alexandre Cabanel, 75015 Paris, France; e-mail: [email protected]; or Daniel Candotti, Institut National de la Transfusion Sanguine, 6 rue Alexandre Cabanel, 75015 Paris, France; e-mail: [email protected].Search for more papers by this authorVirginie Sauvage
National Institute of Blood Transfusion/INTS, National Reference Center for Infectious Risk in Transfusion, Department of Blood-borne Agents, Paris, France
VS and PC contributed equally to this work.Search for more papers by this authorPierre Cappy
National Institute of Blood Transfusion/INTS, National Reference Center for Infectious Risk in Transfusion, Department of Blood-borne Agents, Paris, France
VS and PC contributed equally to this work.Search for more papers by this authorMohamed Abdallahi Boullahi
National Blood Center, Nouakchott, Mauritania
Search for more papers by this authorGuy Olivier Mbensa
National Blood Center, Kinshasa, Democratic Republic of the Congo
Search for more papers by this authorAimée Olivat Rakoto Alson
National Blood Center, Antananarivo, Madagascar
Search for more papers by this authorClaude Tagny-Tayou
Department of Hematology, Faculty of Medicine and Biomedical Sciences of University of Yaoundé I, Yaoundé, Cameroon
Search for more papers by this authorEdward L. Murphy
Departments of Laboratory Medicine and Epidemiology/Biostatistics, University of California, San Francisco, San Francisco, California
Vitalant Research Institute, San Francisco, California
Search for more papers by this authorCorresponding Author
Syria Laperche
National Institute of Blood Transfusion/INTS, National Reference Center for Infectious Risk in Transfusion, Department of Blood-borne Agents, Paris, France
Address reprint requests to: Syria Laperche, Institut National de la Transfusion Sanguine, 6 rue Alexandre Cabanel, 75015 Paris, France; e-mail: [email protected]; or Daniel Candotti, Institut National de la Transfusion Sanguine, 6 rue Alexandre Cabanel, 75015 Paris, France; e-mail: [email protected].Search for more papers by this authorfor The Francophone Africa Transfusion Research Network
Search for more papers by this authorAbstract
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.
CONFLICT OF INTEREST
The authors have disclosed no conflicts of interest.
Supporting Information
| Filename | Description |
|---|---|
| trf15593-sup-0001-TableS1.docxWord 2007 document , 18.7 KB | Table S1. Demographic characteristics of blood donors according to initial serologic status |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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