Journal of Antivirals & Antiretrovirals

Journal of Antivirals & Antiretrovirals
Open Access

ISSN: 1948-5964


Current Trends in the detection of Acute HIV Infection among Blood Donors: Reliability of Pooled Nucleic Acid Amplification Technology and the Need for Population Specific Algorithms: A Systematic Review

Abubakar AG, Ozumba PJ, Winter J, Buttner P4 and Abimiku A

We conducted a systematic review of quantitative studies that evaluated the accuracy of nucleic acid amplification testing technologies (NAAT) compared their cost effectiveness and evaluated minipool NAAT against individual donor testing NAAT. PubMed, Cochrane and Google Scholar were used to identify relevant peerâ��reviewed journal articles published in English language between 1999 (when NAAT was introduced) and 2013. MeSH key words included: Human immunodeficiency virus OR HIV AND nucleic acid amplification techniques OR pooled NAAT AND blood donors. Additional filters include: minipool-NAAT and individual donor testing-NAAT. After screening for duplication and relevance, 50 out of 4,181 articles were selected. Thirty six (36) studies which included 5 review article, 5 retrospective cohort studies, 20 cross sectional studies, 2 statistical modeling’s, 2 national guidelines and 2 prospective cohort studies were further synthesized. Articles were further sub-divided into 8 groups based their focus area which includes: prevalence, clinical sensitivity of the assay, analytical sensitivity, test technology, testing algorithm, limit of detection and cost effectiveness. Four of six studies with pool sizes of 10 to 50 donor plasmas with standard centrifugation recorded a clinical sensitivity of 100% while the remaining two whose plasma pool size of 96 and128 had sensitivities of 92.3% and 95.3%, respectively. All four studies that focused on analytical sensitivity using different samples and controls, including cadaveric samples reported 100% analytical sensitivity using various pool sizes. We recommend minipool NAAT testing after running a third generation ELISA as highly sensitive and cost effective algorithm for low income countries.