Comparative analysis of NAT reactivity and CLIA in detecting transfusion transmitted Infection among blood donors

The effect of Nucleic Acid Testing (NAT) and Chemiluminescent Immunoassay (CLIA) in detecting TTIs (HIV, HBV, HCV, Syphilis and Malaria by rapid card) among 30,335 blood donations, with a focus on 1,843 reactive units is of interest. NAT showed superior sensitivity (98.50% for HBV, 98% for HIV and 97.50% for HCV) compared to CLIA (94.44.0% for HIV, 79.09% for HBV, 64.20% for HCV), but both methods exhibited high false-positive rates (37.7% for NAT, up to 70.6% for CLIA-HCV). NAT had specificity for HIV (98.5%), HBV (98%) and HCV (98%). CLIA exhibited high false positives (HBV: 27.1%, HCV: 16.5%, HIV: 5.7%), while NAT yield identified 106 HBV (0.35%) and 63 HCV (0.2%) additional cases. NAT was cost-effective for HBV and HCV but less so for HIV. Thus, NAT’s role as a highly sensitive screening tool and with CLIA requiring confirmatory testing to optimize blood supply efficiency is shown.