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

## TL;DR

The study compares NAT and CLIA methods for detecting infections in blood donors, finding NAT more sensitive but with higher false positives.

## Contribution

The study provides a comparative analysis of NAT and CLIA for transfusion-transmitted infection detection in blood donations.

## Key findings

- NAT showed higher sensitivity than CLIA for HIV, HBV, and HCV detection.
- NAT identified additional HBV and HCV cases not detected by CLIA.
- CLIA had higher false-positive rates, especially for HCV.

## Abstract

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.