The use of sensitive nucleic acid testing for hepatitis B virus in blood donors revealed a number of HBV DNA(+) cases among HBsAg(-) donors, a status known as occult HBV infection. The purpose of this study was the serological and molecular characterization of occult HBV infection in Greek blood donors. A prospective study was undertaken in order to identify occult HBV infection cases in blood donors. As part of the routine screening of blood donations in Greece, blood units were screened individually by a multiplex HIV-1/HCV/HBV nucleic acid assay. Initially reactive samples were retested with discriminatory assays. HBV DNA(+)/HBsAg(-) samples were tested further for HBV serological markers and HBV DNA was quantified by real-time PCR. Molecular characterization was performed by sequencing the envelope and polymerase genes of HBV. Preliminary screening revealed 21 occult cases with the following patterns: anti-HBc only: 7 donors, anti-HBc/anti-HBs: 7 donors, anti-HBc/anti-HBe: 5 donors, anti-HBc/anti-HBs/anti-HBe: 2 donors. In all cases, the HBV DNA load was <351 IU/ml. Sequencing was successful in 10 donors (classified within genotype D) revealing several amino acid substitutions related to diagnostic escape and antiviral resistance. HBsAg diagnostic failure and low viral replication in occult HBV infection carriers could possibly be attributed to multiple changes in envelope and polymerase regions, respectively.

Methylene-blue-treated fresh-frozen plasma is safer than the untreated product even in patients who require large quantities of plasma transfusion.

Haemovigilance over 11 years has demonstrated the long-term safety of MB-FFP in comparison to untreated quarantine FFP. In addition to lowering the adverse event rate, implementing the system on a national scale in at-risk countries would presumably reduce the transmission of severe viral infections including emerging infectious diseases by transfusion.

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West Nile virus (WNV), a mosquito-borne flavivirus, has increasingly become a concern in both America and Europe due to its complex and unpredictable lifecycle. Transfusion-associated transmission of the WNV has been well documented during the last few years. This study aimed to detect the presence of WNV in: (i) cerebrospinal fluid (CSF) specimens derived from aseptic meningitis cases in Greece and (ii) Greek blood donations. A total of 115 CSF specimens from patients suffering from aseptic meningitis and 9590 blood samples were collected from seven Greek hospitals during the periods June to October 2006 and 2007 and tested for investigational purposes. Both blood and CSF samples were tested for the presence of WNV RNA by using the PROCLEIX WNV assay. None of 115 CSF and 9590 blood donor samples was found positive according to our testing algorithms. Despite the presence of WNV in Balkan countries, WNV has not reached significant levels in Greece.

An 18-years-old female college student was screened as a first-time blood (plateletpheresis) donor and was found to have a highly positive HIV Ab ChLIA (duplicate) test. Negative Western Blot (WB), HIV p24 antigen and NAT HCV RNA/ HIV RNA/HBV DNA assays confirmed that the donor was not infected with HIV. The use of other laboratory tests revealed an acute Epstein Barr infection with positive EBV Viral Capsid Antigen (VCA IgM and VCA IgG) antibodies and also positive Heterophile antibodies. Nonspecific reactivity (false-positive) results of HIV infection, by serological tests, may represent a cross-reaction with other human viruses.

Background and Objectives Sickle cell disease (SCD) and thalassaemia, particularly the β‐type, represent major sources of morbidity. Recommended treatment includes regular blood transfusion following highly uniform strategies across thalassaemia units and monitoring related complications including alloimmunization. This complex problem depends on donor–recipient antigenic diversity, the patient's immune status and specific circumstances such as pregnancy. Materials and Methods We examined alloimmunization against RBC antigens and autoimmunization in 983 patients with thalassaemia and SCD in Greece, in relation to applied RBC antigen matching policies and other factors possibly relevant in reducing the rate of alloimmunization and delayed haemolytic transfusion reaction (DHTR). Results Up to 2010, 11.6% of all patients had history of alloimmunization and 7.3% of autoimmunization. Frequency was highest in thalassaemia intermedia followed by sickle–thalassaemia and thalassaemia major. New alloimmunization was low at 1.4% after 2010, corresponding to a risk of 1:9405 units of RBCs transfused. Despite the very high transfusion burden in the chronically transfused patients, the use of extended matched donor blood is proven effective in reducing the rate of alloimmunization. Conclusion Multiple RBC alloantibodies represent a small but difficult to manage risk for responders prone to combination with autoimmunization. DHTR with hyperhaemolysis is a major clinical problem in haemoglobinopathies, especially during the gestational period and delivery in patients who escape expert medical follow‐up. Progress in the safety and quality of blood transfused in these patients is expected to contribute to prolongation of their life expectancy and to reproduction. Investigation of HLA and other antibodies in patients prone to developing RBC antibodies is suggested.

This first study of symptomatic WNV Lineage 2 suggests A/D negativity as a new risk factor associated with WNV infection and level of morbidity. Further studies are required of the possibility that HLA C*08, DRB1*O4:O5, and DQB1*O2 are protective alleles and DRB1*10:O1 a "susceptible" allele to WNV infection and the role of secretor status in relation to WNV infection.