POOLING STRATEGIES FOR SCREENING BLOOD IN AREAS WITH LOW-PREVALENCE OF HIV

Human immunodeficiency virus (HIV) infection has serious consequences and must be kept out of blood supplies. Screening to ensure the safety of blood supplies is associated with a very high cost. The idea of pooling test samples to obtain significant savings was first suggested in 1943. Recently pooling sera has gained wider interest both as a means to determine the HIV seroprevalence rate in general populations and to weed out all HIV-positive units in blood supplies. We describe a simple method for detecting seropositive samples in mass screening. This method determines the pooling size based on the estimated prevalence rate. Although several repooling stages are allowed, these will be kept to a minimum since the more stages that are required, the greater chance for human and technical errors. The criteria to end pooling are based on both the savings rate and the relative cost between the preparation and the actual test. Two examples illustrate the applications of this method in determining the number of samples to be pooled in successive stages and the resulting savings rate.