1. High rate of hepatitis C virus and human immunodeficiency virus false‐positive results in serologic screening in sub‐Saharan Africa: adverse impact on the blood supply
- Author
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Daniel Candotti, Sekou Oumar Coulibaly, Hadiza Soumana, Virginie Sauvage, Edward L. Murphy, Guy Olivier Mbensa, Claude Tagny-Tayou, Pascal Bizimana, Syria Laperche, Aimée Olivat Rakoto Alson, Mohamed Abdallahi Boullahi, Pierre Cappy, Institut National de la Transfusion Sanguine [Paris] (INTS), Molecular virology and immunology – Physiopathology and therapeutic of chronic viral hepatitis (Team 18) (Inserm U955), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Laboratoire de virologie [Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Département de microbiologie : Bactério, Virologie, Parasito, Hygiène, National Blood Center [Nouakchott, Mauritania] (NBC), National Blood Center [Bujumbura, Burundi] (NBC), National Blood Center [Kinshasa, Democratic Republic of the Congo] (NBC), National Blood Center [Bamako, Mali] (NBC), National Blood Center [Antananarivo, Madagascar] (NBC), National Blood Center [Niamey, Niger] (NBC), University of Yaoundé [Cameroun], University of California [San Francisco] (UC San Francisco), University of California (UC), Vitalant Research Institute [San Francisco], University of California [San Francisco] (UCSF), University of California, Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, and Candotti, Daniel
- Subjects
Adult ,Male ,Hepatitis C virus ,Hepacivirus ,Immunology ,Blood Donors ,HIV Infections ,HIV Antibodies ,030204 cardiovascular system & hematology ,medicine.disease_cause ,Donor Selection ,Serology ,03 medical and health sciences ,0302 clinical medicine ,Antigen ,parasitic diseases ,medicine ,Humans ,Immunology and Allergy ,False Positive Reactions ,Africa South of the Sahara ,[SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,High rate ,biology ,business.industry ,Donor selection ,Blood Screening ,virus diseases ,Hematology ,Hepatitis C Antibodies ,biology.organism_classification ,Hepatitis C ,Virology ,3. Good health ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,HIV-1 ,biology.protein ,Female ,Antibody ,business ,030215 immunology - Abstract
International audience; Background: False positivity in blood screening may cause unnecessary deferral of healthy donors and exacerbate blood shortages. An international multicenter study was conducted to estimate the frequency of HCV and HIV false seropositivity in seven African countries (Burundi, Cameroon, Democratic Republic of Congo, Madagascar, Mali, Mauritania, and Niger).Study design and methods: Blood donations were tested for hepatitis C virus (HCV) and human immunodeficiency virus (HIV) with rapid detection tests (RDTs), third-generation enzyme immunoassays (EIAs), or fourth-generation EIAs. HCV (456/16,613 [2.74%]) and HIV (249/16,675 [1.49%]) reactive samples were then confirmed with antigen/antibody assays, immunoblots, and nucleic acid testing. Partial viral sequences were analyzed when possible.Results: The HCV reactivity rate with RDTs was significantly lower than with EIAs (0.55% vs. 3.52%; p < 0.0001). The HIV reactivity rate with RDTs was lower than with third-generation EIAs (1.02% vs. 2.38%; p < 0.0001) but similar to a fourth-generation assay (1.09%). Only 16.0% (57/357) and 21.5% (38/177) of HCV and HIV initial reactive samples, respectively, were repeatedly reactive. HCV and HIV infections were confirmed in 13.2% and 13.7%, respectively, of repeated reactive donations. The predominant HCV genotype 2 and 4 strains in West and Central Africa showed high genetic variability. HIV-1 subtype CRF02_AG was most prevalent.Conclusion: High rates (>80%) of unconfirmed anti-HCV and anti-HIV reactivity observed in several sub-Saharan countries highlights the need for better testing and confirmatory strategies for donors screening in Africa. Without confirmatory testing, HCV and HIV prevalence in African blood donors has probably been overestimated.
- Published
- 2019