Genomics to Enhance Microbiology Screening (GEMS)

In an era of extraordinary technological developments in medicine, a group of methods called High Throughput Sequencing (HTS) provides revolutionary abilities to both detect and often fully genetically characterise infectious agents present in patient and donor samples. In the proposed programme we will:

• Analyse the potential effectiveness of HTS methods for screening blood and organ donations and compare its abilities with existing testing methods for specific blood-borne pathogens, such as human immunodeficiency virus and hepatitis B virus.
• Investigate how HTS may be harnessed for the longer-term development of “Preparedness”, a strategy that enables a rapid and effective response to emerging threats to blood transfusion safety. This will provide resources for immediate and large-scale investigation of the UK population for the presence of novel and newly spread pathogens. These include the increasing number of mosquito-borne pathogens such as West Nile virus and Usutu virus that have been gradually encroaching into Northern Europe associated with climate change.

The programme will conduct several focused investigations of specific pathogens to address areas of safety concern in current transfusion practice:

• Existing screening tests for hepatitis B virus may not be fully effective in identifying infectious blood or organ donations. We aim to better understand and quantify transmission risks and develop new screening strategies to further reduce this in the future.
• We will investigate how to better determine the risk of HIV and other blood borne pathogens using a range of alternative markers for exposure in donors. These will include looking for evidence of past sexually transmitted diseases, virus infections associated with certain risk behaviours and those with ethnic backgrounds associated with hepatitis B virus infections. Evaluating these will be of major value in selecting blood donors with minimised risk for virus and bacterial transmission.

The research programme will provide important training and research capability development including vital HTS data analysis skills for a large group of scientists and clinicians in training. They will greatly augment the capabilities and responsiveness of NHSBT in the longer term to the threat of infectious disease and allow new technologies to be harnessed for screening.