Sequential serologic testing for common viral markers in blood units in India is probably not cost-effective

摘要

We read with interest the paper by Kania and coworkers1 where they compared simultaneous serologic testing of blood units for human immunodeficiency virus Type 1 (HIV-1), hepatitis B, hepatitis C, and syphilis as against sequential test of all the markers so that if the blood unit is positive for one of the infectious markers then other serologic markers of infection in that unit were not tested. Using this algorithm they showed that almost 90,680 Euros can be saved annually in Burkina Faso where 50,000 blood donations are performed, without losing in the safety of blood products. This leads to a net saving of 1.81 Euros/unit collected in that country. This idea is interesting and hence we applied the strategy theoretically on approximately 7 x 10~6 blood units collected per year in more than 2500 blood banks in India. Calculation of financial savings on sequential strategy, if applied to India, is presented in Table 1 in US dollars, utilizing all four tests, that is, screening for hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV), HIV-1+2, and VDRL. The prevalence data was rounded off from relevant literature.