Use of nucleic acid testing to evaluate the safety of blood and viral genetic diversity among blood donors in Kenya
Mwangi, Joseph M.
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Transfusion of blood and blood products is an important health management strategy for many diseases and health conditions. Despite this benefit, blood transfusion carries the risk of transmitting infectious diseases to the recipients. This is more so when an infected donor is in the window period. In developed countries, residual risk of viral transmission has been minimized through introduction of Nucleic Acid Testing (NAT). In many African countries, where HIV and Hepatitis are among the serious viruses transmissible by blood and blood products, reduction of their transmission remains a major public health challenge. In Kenya, NAT testing has not been introduced since no study has been done to evaluate its potential application in transfusion services and therefore the risk of window period is unknown and availability of safe blood for transfusion remains a challenge. This study was therefore carried out to determine the safety of blood for transfusion from the regional blood donor center, Nairobi. Genomic amplification testing was used to detect HIV, HBV and HCV in donated blood and to determine the genotypes in circulation. A total 814 samples from donated blood were screened serologically and analysed for HIV, Hepatitis B and Hepatitis C by PCR using specific primers. All PCR positive samples were cloned, sequenced and analysed phylogenetically to determine genetic diversity of the viral infections among blood donors. The results of this study showed that 7 samples were HIV positive, 19 samples were HBV positive, and 10 samples were HCV positive by PCR.Serologically negative samples detected for HBV, HCV and HIV were 9, land 0 respectively. Genotype distribution for FITV was Al, G/A2, D, C, D/H, and G. HBV genotypes detected were A, D, and E while HCV genotypes l a and 2b were detected. The findings of this study have important implications in blood safety. It is evident that the current test for donor screening have limitations in sensitivity. Introduction of nucleic acid testing therefore would contribute greatly to improving blood safety.
- MST-Zoological Sciences