Is NAT The Best Screening Modality Of Infectious Disease Seroprevalence in Modern Blood Banking? A Comparative Analysis between Chemiluminescence and ID-NAT in a Tertiary Care Centre

Aims and Objectives: To determine the sero-prevalence of HIV, HBV and HCV infections in blood donors by dual testing strategy using high sensitivity screening assays like enhanced chemiluminescence technology and nucleic acid testing (IDNAT). Introduction: Safe transfusion of blood and blood components saves millions of lives, but unsafe transfusion practices put millions of people at risk of transfusion transmittable infections. Material and Methods: Blood was collected from voluntary and replacement donors and all serum samples were screened for anti HIV 1 and 2 antibody, anti HCV antibody and HBsAg by chemiluminescence and ID-NAT and the results were analysed statistically. Results: Majority of the donors were in the 3rd decade of life,13742 (59.5%); followed by in 4th decade of life, 4547 (19.7%). There were 22303(96.6%) males as compared to 771(3.3%) female donors, with male-female ratio of 28.9:1. Replacement donations were 21392 (92.7%) and voluntary donations were 1682 (7.2%). The seroprevalence of HIV was 29(0.1%), HCV was 160(0.6%), HbsAg was 508(2.2%) and 22377(96.9%) donors were non-reactive by chemiluminescence. The seroprevalence of HIV was 18(0.07%), HCV was 137(0.5%), HbsAg was 598(2.5%) and 22321(96.7%) donors were non-reactive by ID-NAT. The sensitivity, specificity and diagnostic accuracy by chemiluminescence was 97.7%, 95.5% and 97.0% respectively and the sensitivity, specificity and diagnostic accuracy by ID-NAT was99.2%, 96.7% and 99.8% respectively. Conclusion: ID-NAT is superior to Chemiluminescence in detecting infectious blood units in all phases of infection and enhances the safety of the blood and component transfusion.