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Anti-HBc detection in ULTRIO not-repeatable reactive blood donors

Anti-HBc detection in ULTRIO not-repeatable reactive blood donors. Piotr Grabarczyk, Ewa Brojer Institute of Haematology and Transfusion Medicine, Poland. HBV DNA screening in Poland. Obligatory HBV DNA screening in all blood donors since January 2005

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Anti-HBc detection in ULTRIO not-repeatable reactive blood donors

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  1. Anti-HBc detection in ULTRIO not-repeatable reactive blood donors Piotr Grabarczyk, Ewa Brojer Institute of Haematology and Transfusion Medicine, Poland

  2. HBV DNA screening in Poland • Obligatory HBVDNA screening in all blood donors since January 2005 • PCR Cobas in pools of 24 donations (since 2007 in pools of 6) • TMA ULTRIO in single donations

  3. ULTRIO TMA not-repeatable reactives • DEFINITION • Triplex (+) • Discrimination HBV (-); HCV (-); HIV(-) • VERIFICATION METHODS • alternative NAT tests (Cobas, Arthus) • HCV RNA(-), HIV RNA(-) and HBV DNA(-) = false positive triplex assay • HBV DNA – positive:testing for anti-HBc to distinguish occult and window period infection

  4. S/co TMA value and anti-HBc detection in samples reactive in ULTRIO assay(2005) 250 191 donations screened 9 positives (triplex+/dHBV+) 129 not-repeatable S/co of ULTRIO>10reactive (0.05%) 12 HBV DNA (+) in PCR (10%) 5/9 (56%) anti HBc positiveS/co of ULTRIO>10 10/12 (83,3%) anti-HBc positive

  5. Analysis of S/Co distribution in samples with not -repeatable results of ULTRIO TMA Assessment of anti-HBc frequency in all samples with not-repeatable results in ULTRIO TMA Aim of the study (2006)

  6. HBV DNA screening yield in 2006 247 263 donations 1positive 366 not-repeatable reactive(0,14%) 3 (0,8%)HBV DNA positive 363 negative in in PCR PCR S/co of TMA>10

  7. S/co of ULTRIO test in 363 HBV DNA negative not-repeatable samples S/co

  8. Anti-HBc frequency in HBV DNA negative samples with not-repeatable results of ULTRIO test – dependence on S/co value Anti-HBc frequency in donors negative in TMA assay: 7% ULTRIO S/co value

  9. Instead of conclusions • Are the anti-HBc positive donors with not-repeatable ULTRIO results infected with occult HBV with virus load below sensitivity of the assay? • What is the clinical significance of such infections? • Can anti-HBc testing be useful in confirmatory procedure?

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