Evaluation of assays for nucleic acid testing for the prevention of chikungunya and dengue virus transmission by blood transfusion

Transfusion. 2024 Aug;64(8):1503-1508. doi: 10.1111/trf.17921. Epub 2024 Jun 15.

Abstract

Background: The large dengue (DENV) and chikungunya (CHIKV) outbreaks observed during the last decade across the world, as well as local transmissions in non-endemic areas are a growing concern for blood safety. The aim of this study was to evaluate and compare the sensitivity of nucleic acid tests (NAT) detecting DENV and CHIKV RNA.

Materials and methods: Using DENV 1 to 4 International Standards, the limits of detection (LODs) calculated by probit analysis of two NAT assays; the cobas CHIKV/DENV assay (Roche Diagnostics) and the Procleix Dengue Virus Assay (Grifols) were compared. In addition, CHIKV-RNA LOD of the cobas CHIKV/DENV assay was evaluated.

Results: For dengue, the 95% LOD of the cobas assay ranged between 4.10 [CI95%: 2.70-8.19] IU/mL (DENV-2) and 7.07 [CI95%: 4.34-14.89] IU/mL (DENV-4), and between 2.19 [CI95%: 1.53-3.83] IU/mL (DENV-3) and 5.84 [CI95%: 3.84-10.77] IU/mL (DENV-1) for Procleix assay. The Procleix assay had a significant lower LOD for DENV-3 (2.19 vs. 5.89 IU/mL) when compared to the cobas assay (p = 0.005). The 95% LOD for CHIKV-RNA detection of the cobas assay was 4.76 [CI95%: 3.08-8.94] IU/mL.

Discussion: The two NAT assays developed for blood donor screening evaluated in this study demonstrated high and similar analytical performance. Subject to an appropriate risk-benefit assessment, they can be used to support blood safety during outbreaks in endemic areas or in non-endemic areas as an alternative to deferring blood donors during local transmission likely to affect the blood supply. The development of multiplex assays is expected to optimize laboratory organization.

Keywords: NAT; blood safety; chikungunya; dengue; level of detection.

Publication types

  • Evaluation Study

MeSH terms

  • Blood Safety / methods
  • Blood Transfusion
  • Chikungunya Fever* / blood
  • Chikungunya Fever* / diagnosis
  • Chikungunya Fever* / prevention & control
  • Chikungunya Fever* / transmission
  • Chikungunya virus*
  • Dengue Virus*
  • Dengue* / blood
  • Dengue* / diagnosis
  • Dengue* / prevention & control
  • Dengue* / transmission
  • Humans
  • Limit of Detection
  • Nucleic Acid Amplification Techniques / methods
  • RNA, Viral* / analysis
  • RNA, Viral* / blood
  • Sensitivity and Specificity

Substances

  • RNA, Viral