Impact of pooling on accuracy of hepatitis B virus surface antigen screening of blood donations

• Published in: Transactions of the Royal Society of Tropical Medicine and Hygiene Vol. 102; no. 8; pp. 787 - 792
• Main Authors: Novack, L., Sarov, B., Goldman-Levi, R., Yahalom, V., Safi, J., Soliman, H., Orgel, M., Yaari, A., Galai, N., Pliskin, J.S., Shinar, E.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01-08-2008; Royal Society of Tropical Medicine and Hygiene; Elsevier
• Subjects: Antibody; Antigen; Antigen-Antibody Complex - blood; Antigen-Antibody Complex - isolation & purification; Biological and medical sciences; Blood Banks; Blood donation; Blood Donors; Cost-Benefit Analysis; Donor Selection; Feasibility Studies; General aspects; Hepatitis B; Hepatitis B Antibodies - blood; Hepatitis B Antibodies - isolation & purification; Hepatitis B Core Antigens - blood; Hepatitis B Core Antigens - isolation & purification; Hepatitis B Surface Antigens - blood; Hepatitis B Surface Antigens - isolation & purification; Hepatitis B virus surface antigen; Hepatitis B, Chronic - prevention & control; Hepatitis B, Chronic - transmission; Human viral diseases; Humans; Immunoassay - methods; Infectious diseases; Medical sciences; Sensitivity and Specificity; Viral diseases; Viral hepatitis; Viral Load; Antigen; Sensitivity and specificity; Hepatitis B virus surface antigen; Antibody; Blood donation; Hepatitis B; Hepatitis B surface antigen; Hepatic disease; Medical screening; Infection; Viral hepatitis B; Accuracy; Sensitivity; Specificity; Viral disease; Digestive diseases; Tropical medicine
• ISSN: 0035-9203; 1878-3503
• DOI: 10.1016/j.trstmh.2008.04.005

Expenditure on screening blood donations in developing countries can be reduced by testing donations in pools. This study evaluated serological screening in pools for hepatitis B virus (HBV) at the Israeli national blood bank and a hospital blood bank in Gaza, the Palestinian Authority. The accuracy of HBV surface antigen (HBsAg) enzyme immunoassay performed on pools of 3–24 samples was compared with individual tests. Delay in detecting positive samples due to dilution in pools and the possibility of antibody-antigen neutralization were analyzed. The sensitivity of pooled testing for HBsAg was 93–99%, prolonging the window period by 5 days (8.3%). Neutralization of HBsAg by hepatitis B surface antibodies (anti-HBs) could be minimized by testing immediately after pooling. Serological testing for HBsAg in pools may be performed using manually created pools of up to six samples, with 5% loss in sensitivity and a risk of neutralization by anti-HBs present in the donor population. Pooling can therefore be considered as an option only in countries with a low prevalence of HBV.