Screening of hepatitis C (HCV) antibody reactive donors by RT-PCR in a sample population of blood bank donors in Sri Lanka

Abstract

The practice of screening donors for HCV antibodies has substantially lowered the risk of acquiring HCV infection from a transfusion. However, detection of molecular markers in blood is the most reliable means of diagnosing active viral infection. Molecular studies on HCV antibody reactive donors have not been previously performed in Sri Lanka. The present study was carried out to investigate the RNA positive rates in a sample population of anti-HCV antibody reactive blood donors in Sri Lanka, with a view of determining whether RT-PCR testing for HCV RNA should be carried out at the initial donor screening level. Eighty nine (89) HCV antibody reactive donors were tested for the presence of HCV RNA by RT-PCR (sensitivity 200 copies/ml) during the period October 2005 to May 2006. The 89 serology positive donors were initially detected by a third generation ELISA by routine screening of an initial pool of 26,176 blood donors. Of the 89 Anti-HCV antibody positive donors (0.34% of the total donor pool), 6 (0.023% of the total donor pool, and 6.74 % of antibody positive individuals) were positive for HCV RNA. The prevalence of HCVRNA positivity was low in this cohort of Sri Lankan blood donors. This is in keeping with the low prevalence of HCV infection in the community. Routine individual HCV-RNA screening of donors does not seem cost-effective in our setting. The RNA negative, antibody positive profiles reflect either false positive serology results or donors who have been exposed to HCV previously and subsequently resolved their infections.