Neopterin Screening Significantly Improves Safety of Blood Donations

Abstract

Introduction: The transfusion of blood borne infections is one of the most important transfusion associated hazards in many parts of the world specially in developing countries. Potentially hazardous agents include certain viruses, bacteria and parasites such as HIV, HCV, HBV, Syphilis, Malaria and other pathogens. These may remain undetected either because they are known and not screened or they may also be unknown by usual screening methods. Moreover it is also possible that blood is donated during the diagnostic window period. Neopterin is a sensitive indicator of activated cell mediated (T helper cells type1) immune response. Its significant role in blood screening was acknowledged after many years of trials therefore we hypothesized that additional non-specific screening using highly sensitive immune marker like neopterin could significantly improve the safety of blood donations

Study Design: A cross-sectional prospective study

Place and Duration of Study: This study was carried out in the department of Physiology, BMSI in collaboration with JPMC blood bank from May 2011 to Oct. 2011.

Patients and methods: A total of 174 blood donors were included in the study who were screened for HIV, HBV, HCV, Malaria and Syphilis by routine screening (ELISA, RPR and slide method). Serum neopterin level was measured using ELISA.

Results: 174 subjects participating in this study, 21 showed increased serum neopterin levels beyond the acceptable cut-off level of 10nmol/l. Out of them 7 were positive for HBV, 6 for HCV and one of the blood donors was found to have HIV and HCV co-infection. Thus increased neopterin levels were found to be highly significant with a p value of  0.001 in donors having viral infections. Further testing of the remaining 7 samples with increased neopterin level that were seronegative by routine screening, led to the detection of acute CMV infection in three of these donors. These subjects were asymptomatic at the time of donating blood. Three subjects tested positive for syphilis by RPR but their neopterin level was found to be within normal range.

Conclusion: Screening of blood donations for serum neopterin levels significantly increases the safety of blood donations regarding various viral pathogens in a non-specific way.