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NAT yield for human immunodeficiency and hepatitis C viruses in Brazilian blood donors: preliminary results

Dear Sir, In recent reviews of the nucleic acid test (NAT) screening of blood donors worldwide, no data were presented for South America (Zou et al., 2010; Bruhn et al., 2013). Another study reported NAT results from a relatively small South American sample (Roth et al., 2012) but not on a routinely implemented NAT screening of blood donors. However, Brazil has been NAT screening in this population for the human immunodeficiency virus (HIV) and hepatitis C virus (HCV) since 2010. A kit with multiplex HIV/HCV platform has been developed by Bio-Manguinhos® (Fiocruz, Rio de Janeiro, Brazil) with financial support of the Brazilian Ministry of Health and approved for use in December 2011. The number of blood banks with NAT screening routine has reached 14 in 2013, covering all major geographical regions of the country. The aim of this report is to provide the first results of the NAT yield over serological screening in Brazilian blood donors, as well as its variation across major geographical regions of the country. NAT screening of Brazilian blood donors was first piloted in 2010 with the participation of the blood banks from the states of São Paulo, Rio de Janeiro, Pernambuco and Santa Catarina. Systematic data collection started in May 2011 and expanded to 14 blood banks geographically distributed all over the country to facilitate the transportation of blood samples. For the purpose of this study, the period between May 2011 and July 2013 was analysed. The diagnostic kits NAT HIV/HCV was developed by Bio-Manguinhos® (Rio de Janeiro, Brazil) as a multiplex platform for simultaneous and discriminatory detection of HIV and HCV based on real time PCR. The NAT assays detect the viral nucleic acids in the period that precedes the systemic production of antibodies. The amplification reaction is based on RNA targets that require reverse transcription. The flow methodology consists of preparing a minipool of six samples for the RNA extraction step, followed by amplification and detection by PCR in real time. The internal control of the reaction is made of a virus-like particle, added to the minipool during pipetting into the secondary tube. The testing algorithm includes performing first minipool, consisting of 100 μL of six samples, pipetted into a secondary tube. After this step, 265 μL of minipool plasma are used for the extraction and purification of nucleic acids,