03075nas a2200337   4500008004100000022001400041245008000055210006900135260000800204300001200212490000700224520211200231653001702343653002202360653003302382653002602415653001502441653001602456653002702472653003302499653002202532653001102554653001902565653001102584653003202595653002002627653001502647653001202662100001502674856004802689       2004                        eng d  a1246-782000aShould HBV DNA NAT replace HBsAg and/or anti-HBc screening of blood donors?0 aShould HBV DNA NAT replace HBsAg andor antiHBc screening of bloo  cFeb  a26 - 320 v113 aPrevention of transfusion-transmitted hepatitis B virus (HBV) has historically relied on serological screening of blood donors using progressively more sensitive HBsAg assays; in some countries anti-HBc assays have also been employed to detect chronic carriers with low-level viremia who lack detectable HBsAg. Nucleic acid amplification testing (NAT) for HCV and HIV has been successfully introduced to screen donors in many developed countries over the past several years; for logistical and cost reasons HCV/HIV NAT screening has been applied to mini-pools (MP) of eight to 96 donor specimens, with only minimal impact of MP dilutions on clinical sensitivity for interdiction of window period (WP) donations. In several countries (e.g., Japan and Germany), HBV NAT has been added to HIV/HCV MP-NAT blood donor screening with small incremental yields of HBsAg/anti-HBc-negative donations, and the major vendors of NAT systems (Roche and Chiron/Gen-Probe) have been developing triplex assays that include HBV DNA detection capacity without compromising HIV or HCV detection. Pooled specimen HBV NAT has also become the standard of practice for screening source plasma donors, with pressure to include HBV DNA detection as a required procedure for use of recovered plasma in manufacture of fractionated derivatives. However, there is controversy over the magnitude of the incremental yield and clinical benefit of HBV MP-NAT over serological screening strategies, as well as the impact of implementation of HBV NAT on need for retention of HBsAg and anti-HBc screening. This presentation will review recent modeled and empirical data on the value of HBV MP- and individual donation (ID)-NAT for detection of (1) pre-HBsAg WP units and (2) chronic anti-HBc-reactive carriers with undetectable HBsAg. The presentation will also review policy considerations and data that address the potential for discontinuation of either HBsAg or anti-HBc following implementation of HBV NAT. Finally it will address the cost effectiveness of incorporation of HBV DNA detection into HBV screening and NAT testing algorithms.10aBlood Donors10aBlood Transfusion10aCommunicable Disease Control10aCost-Benefit Analysis10aDNA, Viral10aHepatitis B10aHepatitis B Antibodies10aHepatitis B Surface Antigens10aHepatitis B virus10aHumans10aMass Screening10aSafety10aSensitivity and Specificity10aSerologic Tests10aViral Load10aViremia1 aBusch, M P  uhttps://www.notifylibrary.org/reference/269