E992750C 1 Replacement of HIV-1 p24 Antigen Screening with HIV-1 RNA Nucleic Acid Testing (NAT) for Whole Blood Donations S.L. Stramer, R.A. Porter, J.P.

Slides:



Advertisements
Similar presentations
Nick Curry, MD, MPH Infectious Diseases Prevention Section
Advertisements

High Throughput Donor Plasma NAT Screening Assay Applied to Acute HIV Detection in a Public Health Setting December 5, 2007 Josh Goldsmith, Ph.D. National.
Development of a Panel for Dengue Virus Maria Rios, PhD CBER/FDA Blood Products Advisory Committee Meeting December 14, 2010.
A PROSPECTIVE STUDY OF POLYMERASE CHAIN REACTION TESTING ON POOLED PLASMA VS. INDIVIDUAL DONATION HIV P24 TESTING.
Unit 6 Diagnosis & Follow-up of HIV Infection
Supplemental Testing of Donors for HIV and HCV September 18, 2003 BPAC Meeting Robin Biswas, M.D. Indira Hewlett, Ph.D. FDA/CBER/OBRR/DETTD.
Validating 16 Member Pooled APTIMA® HIV-1 RNA testing Ethridge Steven F, Sullivan T, Bennett B, Parker M, Hanson D, Hilliard J, Hart C, Patel P Diagnostic.
The Sense of Sensitivity I Dr. Matthias Gessner Plasma Control Europe/Plasma Analytics Baxter AG, Vienna.
Comparing the New EIAs with Old Standbys: Florida Bureau of Laboratories Verification Data HIV Diagnostics: New Developments and Challenges Feb. 28, 2005.
6/03/031 Hepatitis C –Update Laboratory Issues Hema Kapoor MD. SM Virology Section Manager Bureau of Laboratories Michigan Department of Community Health.
Improved Reflexive Testing Algorithm for Hepatitis C Infection Using Signal-to-Cutoff Ratios of a Hepatitis C Virus Antibody Assay K.K.Y. Lai, M. Jin,
Use of avidity reagent. Panbio Buffered Avidity Reagent Mild protein-denaturing solution that may be useful in differentiating recent infections from.
Karen Cristiano Biologicals Unit, CRIVIB Calibration against the WHO Standards of National Reference Preparations for detection of blood viruses by NAT:
Vironostika® HIV-1 Plus O Microelisa System
Results of donor screening with nucleic acid amplification tests (NAT) and implications for HIV research, diagnosis and surveillance Michael P. Busch,
Alere TM HIV Combo Yuko Tamanoue, Product Development Department.
F. Kourgia, M. Vini, E. Zervou
1 Susan L. Stramer, PhD and collaborators from: American Red Cross, Gaithersburg, MD American Red Cross, Charlotte National Laboratory, Charlotte, NC American.
Screening for HBsAg and Anti-HBc in North American Blood Donors John Saldanha, Roche Molecular Systems SoGAT XXI, May, 2009, Brussels, Belgium.
NAT Yield from Real Time Testing of Organ Donors for HIV-1 RNA and HCV RNA Safer Organs and No False Positive Results Claudia Chinchilla-Reyes, MB(ASCP)1,
HIV Testing CDC power point edited by M. Myers
Management of Risk and Blood Availability in Donor Populations with High Prevalence of Blood Borne Pathogens Ravi Reddy IBSF Meeting 20 March 2015.
Testing Source Plasma for Hepatitis B Virus by Nucleic Acid Testing Blood Products Advisory Committee Meeting Blood Products Advisory Committee Meeting.
HIV Testing Quality Assurance and Quality Control
PROFICIENCY TESTING OF IN-HOUSE NAT ASSAYS USED FOR BLOOD SCREENING XXI SoGAT International Working Group Meeting on the Standardization of NAT for the.
C H I R O N Blood Testing Blood Products Advisory Committee 67th Meeting – September 14, 2000 Detection of HIV-1 p24 antigen positive donor specimens by.
Evaluation of a Proposed Testing Strategy for Laboratory-based Testing Using an HIV-1/2 Discriminatory Assay for HIV: Strategy 5 Data Needs. R. Boromisa,
Pooled Source Plasma NAT for HIV-1 An Update from the Bayer HIV-1 IND Study Barbara Masecar Bayer Corporation Raleigh, NC Blood Products Advisory Committee.
BioLife Plasma Services Experience with HBV NAT Testing
HIV, HCV, and HBV NAT Controls Formulation, Stability and Performance Mark Manak BBI Diagnostics, Inc. A Division of SeraCare Life Sciences, Inc. SoGAT.
Reentry for Donors Deferred Based on Anti-HBc Test Results November 3, 2005 BPAC Meeting FDA/CBER/OBRR/DETTD.
FDA’s Current Considerations of Parvovirus B19 Nucleic Acid Testing (NAT) Mei-ying W. Yu, PhD Division of Hematology CBER/FDA Extraordinary SoGAT Meeting.
Limitations of HIV Antibody Testing in a Population with High Incidence of HIV Infection Joanne Stekler 1,2, Paul D. Swenson 1,2, Robert W. Coombs 1, Joan.
SOGAT Validation of HCV-RNA detection in small test pools on cadaveric samples Marco Koppelman #, Theo Cuypers #, Mirjam de Waal #, Maarten.
Michael Chudy, Paul-Ehrlich-Institut SoGAT XVIII, Bethesda MD
21th VHPB meeting on “Prevention of viral hepatitis in Italy: lessons learnt and the way forward” Catania, 7-8 november 2002 RESIDUAL RISK OF TRANSFUSION-
Maria Rios, Ph.D. CBER/FDA Blood Products Advisory Committee May 1st, WNV Epidemiology & FDA’s Recommendations on the Use of NAT to Reduce the.
E A 1 Parvovirus B19 and HAV Screening of Whole Blood Donations SL Stramer, KL Kane, ML Beyers, RY Dodd, American Red Cross and RIF Smith, National.
Approval Criteria for Assays for Testing Blood Donors for West Nile Virus Robin Biswas, M.D. CBER, FDA Blood Products Advisory Committee Meeting March.
Qualification Panels for West Nile Virus RNA Tests Mark Manak, Ph.D. Boston Biomedica, Inc. West Bridgewater, MA SoGAT Langen, Germany July 3, 2003.
Stability of HCV, HIV-1 and HBV nucleic acids in plasma samples stored at different temperatures Marta José, Rodrigo Gajardo and Juan I. Jorquera Instituto.
Real and perceived problems with Nucleic Acid Testing for organ and tissue donors 5 years experience Claudia Chinchilla, MB(ASCP)1, Dem Brucal, CLS1, James.
Yi-Chen Yang, Yu-Hsuan Chen, Show-Lan Chiu, Hwei-Fang Cheng Drug Biology Division, Bureau of Food and Drug Analysis Department of Health, Taiwan, ROC National.
E WNV Confirmation in US Blood Donors and Data in Support of WNV ID-NAT Triggers Susan L. Stramer, Ph.D. Blood Products Advisory Committee.
1 Procleix ® WNV Assay: A TMA-based Assay for Screening Blood Donations for West Nile Virus RNA Jeff Linnen, Ph.D. Research and Development Gen-Probe Incorporated,
Progress in West Nile virus Testing and Donor Screening Hira Nakhasi, Ph.D. Director, DETTD/OBRR CBER, FDA.
E001372A 1 ARC Experience with Indeterminate Blood Donors Susan L. Stramer, Ph.D. National Confirmatory Testing Laboratory American Red Cross.
SoGAT June 14, 2006 HCV-RNA and HIV-RNA detection in small test pools of cadaveric samples for viral safety of tissue transplants Maarten Koot#,
E A 1 Supplemental Testing for HIV-1 and HCV Blood Products Advisory Committee Meeting September 18, 2003 Susan L. Stramer, Ph.D. National Testing.
Development of Standard Reagents for WNV NAT M. Rios, A. Grinev, K. Sirnivasan, O. Wood, S. Daniel, I. Hewlett CBER/FDA.
Our tryst with Nucleic Acid Testing Dolly Daniel, Dept of Transfusion Medicine, CMC, Vellore.
Management of Donors and Units that Test HBV NAT Positive: Current Considerations July 21, 2005 BPAC Meeting Robin Biswas, M.D. FDA/CBER/OBRR/DETTD.
National Prevalence of Transmitted HIV Drug Resistance in Swaziland in 2011 R. Suzanne Beard, Ph.D. Abstract/poster: TUPDC0103.
DISCONTINUATION OR NO DISCONTIUNATION: COMPARISON OF SINGLE UNIT HIV ANTIGEN TESTING VS. POOLED NAT TESTING Gerald Schochetman, Ph.D. Abbott Laboratories.
An Overall View of Standardization May 26, 2004 Indira Hewlett, Ph.D. CBER/FDA.
E B—Anti-HBc Chart 1 10/2004 Anti-HBc Testing and Donor Reentry Results of a Pilot Study Susan L. Stramer, Ph.D. American Red Cross Blood Products.
CBER Update on status of West Nile virus test, lot release and validation panel development Indira Hewlett, Ph.D CBER/FDA Blood Products Advisory Committee.
Relative Sensitivities of US Licensed NAT Assays for Detection of Viremia in Early HIV and HCV Infection MP Busch, SA Glynn, DJ Wright, D Hirschkorn, ME.
BioPlex 2200 HIV Ag-Ab Assay
Incorporation of NAT into supplemental testing of HCV and HIV seroreactive donors Michael P. Busch representing Blood Systems Research Institute Blood.
Abbott Laboratories ConfidentialPage 1 Update on West Nile Virus George J. Dawson, Ph.D. Abbott Laboratories.
Donations After Reentry
Is Anti-Hepatitis C Virus Antibody Level an Appropriate Marker to Preclude the Need for Supplemental Testing? Intervirology 2015;58: DOI: /
Longitudinal Quality Assurance of HIV Nucleic Acid Testing in Blood Screening D Jardine, S Best, EM Dax (National Serology Reference Laboratory, Australia)
Update on CBER HIV-1 Subtype panel
Viral Safety of Blood Products in Taiwan
NUCLEIC ACID AMPLIFICATION TESTING DETECTS HIV TRANSMISSION RISK IN SEROLOGICALLY- TESTED BLOOD DONOR UNITS. |Presented by Miss Shemau Muniru| Authors:
Trust is good, control is better!
Challenges for Blood Donor Confirmatory Testing Algorithms
Presentation transcript:

E992750C 1 Replacement of HIV-1 p24 Antigen Screening with HIV-1 RNA Nucleic Acid Testing (NAT) for Whole Blood Donations S.L. Stramer, R.A. Porter, J.P. Brodsky, K.J. Waldman, R.Y. Dodd, T.A. Armstrong and G.D. Griffin

E992750C 2 Background uSince the implementation of p24 HIV-1 antigen (Ag) screening in March, 1996, only 5 Ag positive window-case donations have been identified uDue to low Ag yield and the improved sensitivity of NAT screening for HIV-1, replacement of Ag with HIV-1 NAT should be possible

E992750C 3 HIV-1 p24 Antigen Testing Experience During 2 years of testing 14 million donations (ARC), 136 samples were HIV-1 p24 Ag confirmed positive u58 were false positive (based on RNA negativity, lack of seroconversion, and nonreproducible Ag neutralization) = 1:241,379 u74 were HIV Ab positive u4 were recently infected seroconverting donors uAs of November 1999, 5 seroconverting donors identified in 23 million donations –1:4.6 million (ARC) –1:9.2 million (US)

E992750C 4 Samples for Testing up24 Ag and HIV NAT reactive yield samples (N=4) –Tested undiluted and diluted 1:128 in RNA-negative defibrinated plasma uCommercial seroconversion samples (N=25) –Tested undiluted and diluted 1:128 uDiluted p24 Ag “External Control” sample that is tested on all NAT runs (N=437) –3 Ag+/Ab– units (S/CO 1-2 Coulter) pooled –Pool diluted 1:16

E992750C 5 Comparison of HIV-1 p24 Ag Positive Window-Case U.S. Blood Donors 1Index6 x 10 5 *14.0* x POS – minus p x POS – all bands 2Index2 x 10 6 *28.5* x POS – minus p17, p x POS – all bands 3Index1 x x 10 5 *26.5*908.8POS – minus p31 4Index1 x x 10 6 *17.5*892.7IND – p x POS – all bands 5Index3 x * x 10 5 *0.24.3POS – minus p x POS – minus p x POS – minus p x POS – minus p31 SC Sample Collection (days) WB RNA Copies/mL p24 Ag S/CO Percent Neut. HIV-1/ HIV-2 Ab S/CO

E992750C 6 Detection of HIV-1 p24 Ag and NAT Yield Samples by HIV-1 NAT (1:128 Dilution) ARC 2Ag6x10 5 +(16.08) ARC 3Ag1x10 5 +(16.06) ARC 5Ag3x10 5 +(29.59) MilwaukeeNAT2x10 4 +(7.86) Case Index Detected By Index RNA Conc. Undiluted (copies/mL) Multiplex 1:128* (S/CO) * Diluted in RNA screened negative defibrinated plasma

E992750C 7 HIV Panel 6240 – Virologic/Serologic Profile Days S/CO HIV PCR Quantitation PCR 5 Days 2 Days

HIV Panel 6240 – Virologic/Serologic Profile Days S/CO HIV PCR Quantitation 2 Days 1:128 7 Days Neat E992750C 8 PCR 5 Days

PCR Days S/CO HIV PCR Quantitation HIV Panel PRB932 – Virologic/Serologic Profile Cutoff E992750C 9

PCR Days S/CO HIV PCR Quantitation HIV Panel PRB932 – Virologic/Serologic Profile Cutoff E992750C Days

HIV Panel PRB943 – Virologic/Serologic Profile Days S/CO HIV PCR Quantitation PCR Cutoff E992750C Days 2 Days

PCR HIV Panel PRB943 – Virologic/Serologic Profile Days S/CO HIV PCR Quantitation Cutoff E992750C 12 5 Days 7 Days 2 Days

E992750C 13 Clinical Sensitivity, HIV Panels, Gen-Probe Multiplex Assay S/CO (Neat) p24 Antigen S/CO Cutoff Lot HIV Seronegative Bleeds (92 samples from 25 individuals) 29 NAT +/p24 Ag –

E992750C 14 Cutoff Clinical Sensitivity, HIV Panels, Gen-Probe Lot HIV Seronegative Bleeds (92 samples from 25 individuals) Multiplex Assay S/CO (1:128) p24 Antigen S/CO 21 NAT +/p24 Ag – 1:128

E992750C 15 Effect of Dilution on NAT Reactivity (Gen-Probe HIV-1/HCV Assay) Lot 355 HIV-1 (N=25 Panels) Lot 356 HCV (N=22 Panels) Lot 355 Lot 356 Undiluted Diluted 1: (90%)148 (89%)151 (93%) 151 (94%) p24 Ag82 (57%)82 (55%)—— ALT (  60)——50 (44%)*49 (43%)** * Of 114 tested; ** Of 113 tested * Of 114 tested; ** Of 113 tested

E992750C 16 Gen-Probe Linked Study – Phase I External Control Panel Member HIV-1300 ± 150 HCV 300 ± 150 NEG— Weak HIV-1 p24 Ag (S/CO 1-2 Coulter diluted 1:16)6,800 Target Copies/mL

Gen-Probe Linked Study – Phase I External Control Distributions Frequency S/CO ControlN Mean S/CO Range HIV *8.9 –37.6 HCV *2.1 –10.4 NEG –0.9 HIV-1/p24 Ag *12.1 –25.2 *p<0.05 (437 runs total) 0 E992750C 17

E992750C 18 Conclusions  High RNA titers (  10 5 copies/mL) correspond with p24 Ag positivity uNo p24 Ag reactive sample was found NAT nonreactive even using a pool size of 128 uNAT, even using pools of 128, is more sensitive than screening with the currently licensed tests for HIV-1 p24 Ag. According to these data, the Ag test could be replaced by the use of licensed pooled NAT

E992750C 19 Linear Relationship Between HIV RNA Levels and p24 S/CO Ratios 4.03 log ( ,108 copies/mL) = 1

E992750C Log HIV RNA Level [copies/mL] Log p24 S/CO N = % Prediction Limits for Relationship of HIV RNA Levels and p24 S/CO Ratios

E992750C Log HIV RNA Level [copies/mL] RNA Only (N=61)p24 Pos (N=85) P = <0.0001* * Mann-Whitney Test HIV-1 RNA Levels During “RNA Only” and “p24 Positive” Window Periods

E992750C Log RNA Level [copies/mL] Log p24 S/CO Linear Relationship Between HIV-1 RNA Levels and p24 S/CO Ratios in 32 Cases