Nucleic Acid Testing - Past, Present and Future - Focus on HIV, HCV, and HBV

Publication Date: 26 January 2026

Continuing Education Credits: 0.5 hours

Course Description

In this lecture, Dr. Susan L. Stramer, PhD, MS, presents a comprehensive overview of the evolution, impact, and future directions of nucleic acid testing (NAT) in blood safety. She begins by outlining the historical context of NAT’s introduction in the United States in 1999, initially implemented for HIV and HCV to enhance blood safety by enabling earlier detection of infections compared to serological methods. Dr. Stramer highlights the significant reduction in transfusion-transmitted infections (TTIs) due to NAT, with current risks estimated at less than 2 per million units. Over time, NAT has expanded to include detection of other pathogens such as West Nile Virus (WNV), Zika Virus (ZIKV), and Trypanosoma cruzi. The primary advantage of NAT lies in its ability to detect infectious agents before antibodies become detectable, thereby narrowing the diagnostic window. The lecture also explores the technological evolution of NAT, including methods such as polymerase chain reaction (PCR), transcription-mediated amplification (TMA), and recombinase polymerase amplification (RPA). Additional considerations discussed include sample pooling strategies, pool sizes, and other operational aspects that influence the sensitivity and efficiency of NAT in blood screening.

Lecture Objectives

Demonstrate the improvements in safety afforded by the addition of infectious disease screening tests for donated blood
Assess the impact of nucleic acid testing on blood product safety

Run Time: 38:29

Course Instructor Bio(s)

Susan Stramer, PhD, MS

Infectious Disease Consultant
North Potomac, MD

Susan L. Stramer, PhD, MS is currently an Infectious Disease consultant, having recently retired after serving 28 years at the American Red Cross with her last position for 10 years as the Vice President of Scientific Affairs in Biomedical Services. Her primary interests are the agents of infectious diseases transmitted by blood, their epidemiology, and interventions, particularly related to developmental diagnostics. To date, she has authored over 290 peer-reviewed papers and received numerous awards including those from the American Red Cross, Gulf Coast Regional Blood Center, the California Blood Bank Society, the Association for the Advancement of Blood and Biotherapies (AABB), the International Society for Blood Transfusion (ISBT), the U.S. Centers for Disease Control and Prevention, and the National Institutes of Health. She is a past president of the AABB, past chair of the Transfusion-Transmitted Diseases Committee of the AABB, and serves on several committees of the ISBT. She is also on the editorial board of Transfusion Medicine Reviews and an associate editor for the journal Transfusion. She has delivered talks on blood safety on six continents and in at least 50 countries.

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