Detection, characterization, and enrollment of donors of Ebola convalescent plasma in Sierra Leone

Richard S. Tedder*, Dhan Samuel, Steve Dicks, Janet T. Scott, Samreen Ijaz, Catherine C. Smith, Charlene Adaken, Christine Cole, Samuel Baker, Tansy Edwards, Philip Kamara, Osman Kargbo, Saidia Niazi, Davis Nwakanma, Umberto d'Alessandro, Graham Burch, Heidi Doughty, Colin Brown, Nicholas Andrews, Judith R. GlynnJohan van Griensven, Georgios Pollakis, William A. Paxton, Malcolm G. Semple

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

21 Citations (Scopus)

Abstract

BACKGROUND: Passive therapy with convalescent plasma provides an early opportunity to intervene in Ebola virus disease (EVD). Methods for field screening and selection of potential donors and quantifying plasma antibody are needed. STUDY DESIGN AND METHODS: Recombinant Ebola virus glycoprotein (EBOV GP) was formatted into immunoglobulin G-capture, competitive, and double-antigen bridging enzyme immunoassays (EIAs). EVD survivors in Freetown, Sierra Leone, were recruited as potential plasma donors and assessed locally using sera alone and/or paired sera and oral fluids (ORFs). Uninfected controls comprised unexposed Gambians and communities in Western Area, Sierra Leone. Antibody neutralization in selected sera was measured retrospectively in a pseudotype virus assay. RESULTS: A total of 115 potential donors were considered for enrollment: 110 plasma samples were concordantly reactive in the three EIAs; three were concordantly unreactive and two were reactive in two of three EIAs (98.2% agreement; 95% confidence interval [CI], 93.9%-99.8%). In 88 donors with paired ORF and plasma, G-capture EIA reactivity correlated well in the two analytes (R2 = 0.795). Plasma and ORF from 44 Gambians were unreactive. ORF samples from 338 of 339 unexposed Western Area community controls were unreactive (specificity, 99.7%; 95% CI, 98.4%-99.7%); ORF samples from 113 of 116 Kerry Town EVD survivors were reactive (sensitivity, 97.4%; 95% CI, 92.5%-99.5%). Strong reactivity in G-capture and/or competitive EIAs identified donors with high plasma EBOV GP antibody levels in the double-antigen bridging assay, correlating with high levels of neutralizing antibody. CONCLUSIONS: In-field testing can qualify convalescent donors for providing high-titer antibody.

Original languageEnglish
Pages (from-to)1289-1298
Number of pages10
JournalTransfusion
Volume58
Issue number5
DOIs
Publication statusPublished - May 2018

Bibliographical note

Funding Information:
The study “Convalescent plasma for early Ebola virus disease in Sierra Leone” (ISRCTN13990511 and PACTR201602001355272) was supported by the Wellcome Trust (Award 106491) and Bill and Melinda Gates Foundation; Public Health England Ebola Emergency Response; and the Blood Safety Programme, National Health Service Blood and Transplant. JTS was supported by the Wellcome Trust. MS was supported by the UK National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections. The study of Kerry Town survivors and community controls was supported by Save the Children internal funds and The Wellcome Trust’s Enhancing Research Activity in Epidemic Situations (ERAES) program (Grant ER1502). JvG was supported by the European Union Horizon 2020 research and innovation program (Grant 666094). The funders had no role in the collection and analysis of the samples, in the interpretation of data, in writing the report, nor in the decision to submit the paper for publication.

Publisher Copyright:
© 2018 The Authors Transfusion published by Wiley Periodicals, Inc. on behalf of AABB.

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