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2. 37āļïāļāļĩāđ 45 āļāļāļąāļāļāļĩāđ 2 āļāļĪāļĐāļ āļēāļāļĄ 2555
Abstract
Background: The Nucleic Acid AmpliïŽcation Technology (NAT) was used to screen the hepatitis
B, hepatitis C and HIV in blood donations at Maharaj Nakorn Chiang Mai Hospital in order to decrease the
risk of blood transfusion and enhance the safety of the blood supply. We aim to evaluate the performance
of two commercial multiplex NAT tests, the Chiron eSAS Procleix Ultrio test (Ultrio test) and the Roche
CobasÂŪ s201 automated platform and the Cobas TaqScreen MPX test (MPX test).
Methods: A total of 105,399 seronegative samples tested by Chemiluminescent micro-particle
immunoassay (Architect Abbott, Wies-baden, Germany) during August 2008âMarch 2012 was performed
by NAT. The 53,435 samples were tested individually on the Procleix Ultrio Assay, Transcription Mediated
AmpliïŽcation (TMA: Chiron Corporation, Emeryville, CA) for the simultaneous detection of HBV, HCV and
HIV-1. On the alternate day 51,964 samples were tested in pools of 6 with the MPX test of The Roche
Cobas s201 platform which was an automated platform for blood screening and the MPX test which was
a multiplex NAT test for the simultaneous detection of HBV, HCV, HIV-1 and HIV-2. All reactive samples
were retested by duplicate testing, using sample taken from the plasma bag and checked by both Nat
test, to calculate the test speciïŽcity. The donors were then followed up and new blood samples were
repeated by both methods to conïŽrm the infectivity.
Results: Test speciïŽcity was 99.82% and 99.89% for the Procleix Ultrio and Cobas TaqScreen
tests, respectively. Two HIV-1 NAT- reactive donors were detected by the Cobas MPX test in pools of 6.
These two samples were also detected when tested individually with the Ultrio test. One hundred and six
positive cases of HBV were found, with 65 samples detected by the MPX test, and 41 detected individu-
ally with the Ultrio test. No HCV was positive in this study. The NAT yield rate for HIV-1 and HBV were
1:52,699 and 1:994, respectively. Follow up of the donors showed that several of the HBV yield samples
were from donors with occult HBV.
Conclusions: Both NAT assays were able to detect infectious samples that were missed by
routine serological assays. Window period HIV-1 and HBV donations, as well as donations from donors
with occult HBV were detected by both assays. The speciïŽcally and sensitively NAT showed the increas-
ing rate of detection especially for HBV. The assay features of automation and multiple target detection of
NAT greatly improved the eïŽciency of the screening and greatly increase blood safety. It is imperative that
blood transfusion services have eïŽective screening system especially in the highly endemic region such
as northern Thailand.
āļŠāļĢāļļāļ: āļāļēāļĢāļāļĢāļ§āļāļāļĢāļāļāđāļĨāļŦāļīāļāļāļĢāļīāļāļēāļāđāļāļĒāļ§āļīāļāļĩ NAT āļāļąāđāļāļŠāļāļāļ§āļīāļāļĩāđāļŦāļĄāļēāļ°āļŠāđāļēāļŦāļĢāļąāļāļāđāļēāļĄāļēāļāļĢāļ§āļāļŦāļēāđāļāļ·āđāļāđāļ§āļĢāļąāļŠāļāļĩāđāļĄāļĩāļāļĢāļī
āļĄāļēāļāļïāļāļĒāđ āđāļĨāļ°āđāļĄïāļŠāļēāļĄāļēāļĢāļāļāļĢāļ§āļāļāļāļïāļ§āļĒāļ§āļīāļāļĩāļāļĩāđāļĢāđāļĨāļĒāļĩ āđāļï āļāļēāļāļāļēāļĢāļĻāļķāļāļĐāļēāļāļĢāļ§āļāļāļāđāļāļ·āđāļ HIV-1 āđāļĨāļ° HBV āđāļāļïāļ§āļ
window period āđāļāļāļđïāļāļĢāļīāļāļēāļāđāļĨāļŦāļīāļāļĢāļ§āļĄāļāļąāđāļāļāļēāļĢāļāļĢāļ§āļāļāļ occult HBV āđāļāļāđāļāđāļĨāļĒāļĩ NAT āļĄāļĩāļāļ§āļēāļĄāļāđāļēāđāļāļēāļ°āđāļĨāļ°āļāļ§āļēāļĄ
āđāļ§āļŠāļđāļāļŠāļēāļĄāļēāļĢāļāđāļāļīāđāļĄāļāļĢāļ°āļŠāļīāļāļāļīāļ āļēāļāļāļēāļĢāļāļĢāļ§āļāļāļĢāļāļāļāļēāļĢāļāļīāļāđāļāļ·āđāļāđāļāļāļđïāļāļĢāļīāļāļēāļāđāļĨāļŦāļīāļāđāļāļĒāđāļāļāļēāļ°āļāļĒïāļēāļāļĒāļīāđāļ HBV āđāļïāļāļāļēāļĢāđāļāļīāđāļĄ
āļāļ§āļēāļĄāļāļĨāļāļāļ āļąāļĒāđāļāļāļđïāļï āļ§āļĒāļāļĩāđāļïāļāļāļĢāļąāļāļāļēāļĢāļĢāļąāļāļĐāļēāđāļāļĒāļāļēāļĢāđāļŦïāđāļĨāļŦāļīāļ āļāļķāļāđāļïāļāļāļ§āļēāļĄāļāđāļēāđāļïāļāļāļĩāđāļāļēāļāļāļĢāļīāļāļēāļĢāđāļĨāļŦāļīāļāļāļ§āļĢāļĄāļĩāļ§āļīāļāļĩāļāļēāļĢ
āļāļĢāļ§āļāļāļĢāļāļ NAT āļāļĩāđāļĄāļĩāļāļĢāļ°āļŠāļīāļāļāļīāļ āļēāļ āđāļāļĒāđāļāļāļēāļ°āđāļāļïāļāļāļāļīāđāļāļāļĩāđāļĄāļĩāļāļēāļĢāļĢāļ°āļāļēāļāļŠāļđāļāđāļïāļāļ āļēāļāđāļŦāļāļ·āļāļāļāļāļāļĢāļ°āđāļāļĻāđāļāļĒ
9. 44 āļ§āļēāļĢāļŠāļēāļĢāđāļāļāļāļīāļāļāļēāļĢāđāļāļāļĒïāđāļāļĩāļĒāļāđāļŦāļĄï
āđāļāļāļŠāļēāļĢāļïāļēāļāļāļīāļ
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