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    Transfusion Transmitted Infections

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    Sadio Keita
    1. This document discusses transfusion transmitted infections (TTIs), their characteristics, mandatory testing, and methods for notification. 2. It outlines the key agents that can cause TTIs including viruses, bacteria, parasites, and prions. Hepatitis B, hepatitis C, and HIV are among the most common viral TTIs. 3. Mandatory testing in India includes screening all blood and blood components for hepatitis B, HIV, hepatitis C, syphilis, and malaria using techniques like ELISA, rapid tests, chemil

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    Transfusion Transmitted Infections

    Uploaded by

    Sadio Keita
    162 views30 pages
    1. This document discusses transfusion transmitted infections (TTIs), their characteristics, mandatory testing, and methods for notification. 2. It outlines the key agents that can cause TTIs including viruses, bacteria, parasites, and prions. Hepatitis B, hepatitis C, and HIV are among the most common viral TTIs. 3. Mandatory testing in India includes screening all blood and blood components for hepatitis B, HIV, hepatitis C, syphilis, and malaria using techniques like ELISA, rapid tests, chemil

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    Transfusion-Transmitted-Diseases

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    1. This document discusses transfusion transmitted infections (TTIs), their characteristics, mandatory testing, and methods for notification. 2. It outlines the key agents that can cause TTIs including viruses, bacteria, parasites, and prions. Hepatitis B, hepatitis C, and HIV are among the most common viral TTIs. 3. Mandatory testing in India includes screening all blood and blood components for hepatitis B, HIV, hepatitis C, syphilis, and malaria using techniques like ELISA, rapid tests, chemil

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    162 views30 pages

    Transfusion Transmitted Infections

    Uploaded by

    Sadio Keita
    1. This document discusses transfusion transmitted infections (TTIs), their characteristics, mandatory testing, and methods for notification. 2. It outlines the key agents that can cause TTIs including viruses, bacteria, parasites, and prions. Hepatitis B, hepatitis C, and HIV are among the most common viral TTIs. 3. Mandatory testing in India includes screening all blood and blood components for hepatitis B, HIV, hepatitis C, syphilis, and malaria using techniques like ELISA, rapid tests, chemil

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 30

    TRANSFUSION TRANSMITTED INFECTIONS

    CONTENTS

    • TTI ?
    • Characteristics of TTI
    • Mandatory TTI
    • Methods/Technologies for TTI Testing
    • TTI Notification
    • Why & How To Notify
    TRANSFUSION CHAIN
    Human
    being
    (Donor)
    Blood donors Each link consists of
    several
    Collection smaller links
    (primary processes)
    Processing

    Screening
    and testing
    The quality of the BTS is
    Blood cold
    influenced by the quality
    chain
    of each of the links
    Human
    Transfusion being
    (Patient)
    TTI = TRANSFUSION TRANSMISSIBLE INFECTIONS

    A pathogen :
    • Able to transmit through blood or blood components
    • Able to survive outside human body
    • Able to survive through range of temperatures
    • Able to replicate and re-establish following transfusion
    • Exists naturally either free in plasma or in cellular component
    INFECTIOUS AGENTS
    1. Virus – most commonly transmitted
    2. Bacteria
    3. Protozoa
    4. Fungi – not accepted as blood donor(too sick)
    5. Parasite
    6. Prion
    VIRUS
    1. Hepatitis: Hep B, Hep C, Hep D
    2. Human immunodeficiency virus (HIV)
    3. Human T-cell Lymphotrophic virus (HTLV-1,2)
    4. Epstein barr virus (EBV)
    5. Cytomegalo virus (CMV)
    6. West nile virus (WNV)
    7. Human herpes virus (HHV)
    BACTERIA

    1. Treponema pallidum
    2. Yersinia enterocolitica
    3. Pseudomonas
    4. Propionibacterium acnes
    5. Staphylococcus epidermidis
    6. Bacillus cereus
    PARASITES

    1. Plasmodium species
    2. Babesia microti
    3. Trypanosoma Cruzi
    4. Leishmania species
    5. Toxoplasma gondi
    PRIONS

    Creutzfeld Jacob disease / Variant Creutzfeld Jacob disease


    CHARACTERISTICS OF TTI

    • Asymptomatic or only mild symptoms in donors –hence pass


    donor screening criteria

    • Long incubation period before clinical signs and symptoms


    appear

    • Stability in blood at 4OC or lower

    • Might cause a carrier state of infection (HBV, HCV)


    HOW AND WHAT TO TEST ?

    • Identify structural protein


    • Identify antibody produced
    • Identify antigen
    • Identify nuclear material
    HOW TO TEST?
    • Rapid tests
    • ELISA
    • Chemiluminescence assay(CLIA)
    • Nucleic Acid Amplification Testing (NAT)
    SELECTION OF SCREENING ASSAYS
    • What is the test?
    • Who is going to use it?
    • Is the staff experienced or newly recruited?
    • What are the constraints?
    • Are resources available?
    • Are results needed in a very restricted period of time?
    • How is it to be used? Large or small number of
    specimens?
    • What are the existing systems?
    MANDATORY TTI TESTING
    Under Drugs and Cosmetic Act 1940
    Rules 1945 amendments thereafter, (SCH. F, Part XII B)
    Ministry of Health And Family Welfare
    Government of India
    Screening of each blood & blood components is Mandatory
     HBsAg
     Anti HIV 1 & 2
     Anti HCV
     VDRL
     Malarial parasite
    MANDATORY TTI TESTING
    HIV 1 & 2, Hepatitis C,, Hepatitis B Syphilis & Malaria

    1. Screening for antibodies to HIV-1 & 2


    ( Rapid/3rd or 4th generation ELISA /Chemiluminescence and / NAT )

    2. Screening for antibodies to HCV


    ( Rapid/3rd or 4th generation ELISA /Chemiluminescence and / NAT )

    3 Hepatitis B Surface Antigen


    ( Rapid/ 3rd or 4th generation ELISA /Chemiluminescence and / NAT )

    4. Syphilis ( TPHA/VDRL/RPR )

    5. Malarial parasite (PBF / Rapid card test )


    MANDATORY BLOOD SCREENING FOR INFECTIOUS
    MARKERS
    Infectious Year of Mandatory Testing Newer Technologies
    Markers Enforcement Technology

    Syphilis 1975 RPR/VDRL/TPHA ELISA

    Hepatitis B 1975 ELISA/Rapid Chemiluminescence/NAT


    virus

    Malaria 1975 Smear/Rapid ELISA

    HIV 1988 ELISA/Rapid Chemiluminescence/NAT

    Hepatitis C 2001 ELISA/Rapid Chemiluminescence/NAT


    Virus
    RECENT CONCERNS

    • Latency and carrier state leading to persistent infections: HIV, HBV,


    HCV were major concerns but Hep A and Hep E

    • Emerging infections like Dengue Virus ,West Nile Virus, Zika Virus,
    and others are posing risk for infection
    VARIOUS TESTING TECHNOLOGIES
    Technology Window Period
    HIV HCV HBV
    ELISA-III Generation 20.6 days 58.3 days 36.3 days

    ELISA-IV 13.7 days 9.4 days 24 days


    Generation
    ID NAT 5.6 days 4.9 days 20.6 days
    IDEAL ELISA PLATE(96 wells) LAYOUT
    RAPID TESTS
    Employ a variety of techniques
    • Dot blot assays
    • Particle agglutination
    • Spot tests
    • Immuno- chromatographic tests or Card Tests
    • Most have sensitivities and specificities of 99% and 98%
    respectively

    Applications of Rapid tests


    • Useful in small blood banks
    • Useful in emergency
    RAPID IMMUNOCHROMATOGRAPHIC ASSAY

    POSITIVE NEGATIVE INVALID


    MALARIA CARD TEST

    NEGATIVE POSITIVE INVALID


    CHEMILUMINESCENCE
    IMMUNOASSAY
    • Principle: It is the production of light [Luminescence] from an
    oxidation-reduction chemical reaction.
    • Two chemicals react to form an excited (high-energy) intermediate,
    which breaks down releasing its energy as photons of light and
    interpreted as Optical density value.
    NAT NAT TESTING
    DONOR NOTIFICATION

    Why should the donors be informed of test results?


    • Results are significant to their health NBTC/NACO
    • Ensures no further donations Recommendation

    • Unethical to hold information


    • Informing about Pathology - acute and chronic
    • Secondary transmission - sexual, mother to child, close physical contact
    • Mode of infection-why not excluded by donor selection
    • Treatment and management
    • General surveillance and epidemiology
    • acute infection (WP)
    • To improve testing methodology
    HOW TO NOTIFY ?

    • Follow NACO/NBTC policy on how to notify donors about positive TTI


    • Tell the results on a face-to-face basis
    • Counsellor - well-trained in counselling skills

    • Given in person, never on telephone

    • Maintain confidentiality

    • Opportunity to ask questions / discussion

    • Further appointment offered


    REFERRAL

    • Refer the donor to other sources of advice and support


    HIV - ICTC (Integrated Counselling and Testing Center)
    HBV/HCV - Medicine / Gastro/ Hepatologist
    Syphilis - Dermatology / STD Clinic
    Malaria - Physician /Medicine
    IMPACT ON BLOOD DONORS

    • What will the test result mean?


    • Will I become ill?
    • What about my partner / offspring?
    • Am I infectious?
    • How did I become infected?
    • Is infection treatable?

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