EVALUATION OF A POOLING METHOD FOR ROUTINE ANTI-HCV SCREENING OF BLOOD-DONORS TO LOWER THE COST BURDEN ON BLOOD-BANKS IN COUNTRIES UNDER DEVELOPMENT

A pooling system was developed for use in anti-HCV screening of volunt ary blood donors at the local Central American Red Cross blood banks, in Nicaragua, EI Salvador and Honduras. The commercially available sec ond generation anti-HCV screening kit from Abbott Laboratories (North Chicago, IL) was used with a modification in the initial serum dilutio n procedure. Pools of five sera were selected for routine screening, b ased on comparative studies of individual samples and of pools with di fferent sample sizes. During the years 1993 and 1994 a total of 89,148 voluntary blood donors were screened and a positive prevalence rate o f 0.35% was established. Of the initially positive samples, 54% confir med positive, 30% were indeterminate and 16% were negative using the A bbott Matrix test. Significant differences of positive screening preva lence rates were found in the three countries, with average values of 0.50%, 0.23% and 0.08%, respectively, in Nicaragua, EI Salvador and Ho nduras. These initially positive samples also showed a different confi rmatory pattern with a positive rate of 64% in Nicaragua, in contrast to 20% in El Salvador. Only a few samples were available for RT-PCR am plification of HCV-RNA; however, this highly sensitive method did not appear to be more helpful than serology in confirming the HCV donor st atus.Overall, the data obtained indicate a fluctuation of HCV prevalen ce in voluntary blood donors among the three Central American countrie s. Further, differences were found in the percentages of initially scr eened positives and confirmation patterns. This information appears us eful for establishing criteria in future screening policies. Thus, we suggest that the use of pooling for anti-HCV screening is beneficial i n countries under development, since there are potential cost savings, as well as benefits in establishment of initial prevalence rates. (C) 1996 Wiley-Liss, Inc.