Publication

Abstract : Introduction Patients undergoing haemodialysis are vulnerable to Blood Borne Viral (BBV) infections. Longer duration of dialysis and blood transfusion increases the risk of blood borne infections in this susceptible population. Aim To detect Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) infections using Nucleic Acid Testing (NAT) in dialysis patients who were seronegative by conventional serological assay. Materials and Methods This was a prospective cross-divtional study in patients on maintenance dialysis. Patients who were known serology reactive for BBV were excluded. Risk factors for BBV infection in dialysis patients were collected. NAT was performed using Individual Donor Procleix Ultrio Plus Assay. Categorical variables were expressed in frequency and continuous variable as median with Interquartile Range (IQR). Correlation was performed to determine association of duration of dialysis with the volume of RBC transfusions. Results Eighty eight patients non-reactive for Anti HIV, Anti HCV and HBsAg by serology were screened by NAT assay. Median Red Blood Cell (RBC) units transfused per patient was 5. There were 12.5% (n=11) patients included in the study who had undergone dialysis at more than one centre. Median duration of dialysis was 30 months. NAT assay was non-reactive in all 88 patients. Conclusion Screening results for chemiluminescence and NAT assays were similar. Proper sterilisation protocols, isolation for BBV positive patients, use of NAT screened blood components for transfusion, less patients undergoing dialysis outside the centre and low prevalence of infection are responsible for NAT negative test results. Chemiluminescence assay was found adequate for routine screening to prevent BBV disease transmission in patients undergoing dialysis.