HBV vaccination of HCV-infected patients with occult HBV infection and anti-HBc-positive blood donors

Pereira, Josiane Silveira Felix; Gonçales, Neiva Sellan Lopes; Silva, Cinthia Aparecida da; Lazarini, Mariana; Pavan, Maria Helena Postal; Fais, Viviane Cristina; Júnior, Fernando Lopes Gonçales

doi:10.1590/s0100-879x2006000400013

Cited by 13 publications

(8 citation statements)

References 28 publications

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“…Those authors ascribed this result to the low prevalence of HBV infection in the State of São Paulo. In two other investigations conducted in the State of São Paulo, OBI was diagnosed by nested PCR in sera of 12 of 50 (24%) (20) and 15 of 106 (14%) anti-HBc positive patients with chronic HCV infection (21). Differences in techniques, and the fact that all patients enrolled in these last two studies had markers of previous HBV infection, probably explain the differences in OBI prevalence in these investigations, our study, and that of Alencar et al (19).…”

Section: Discussionmentioning

confidence: 99%

Occult hepatitis B virus infection in liver transplant patients in a Brazilian referral center

Ferrari

Xavier

Vidigal

et al. 2014

Braz J Med Biol Res

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Estimates of occult hepatitis B virus (HBV) infection prevalence varies among different studies depending on the prevalence of HBV infection in the study population and on the sensitivity of the assay used to detect HBV DNA. We investigated the prevalence of occult HBV infection in cirrhotic patients undergoing liver transplantation in a Brazilian referral center. Frozen liver samples from 68 adults were analyzed using a nested polymerase chain reaction assay for HBV DNA. The specificity of the amplified HBV sequences was confirmed by direct sequencing of the amplicons. The patient population comprised 49 (72.1%) males and 19 (27.9%) females with a median age of 53 years (range=18-67 years). Occult HBV infection was diagnosed in three (4.4%) patients. The etiologies of the underlying chronic liver disease in these cases were alcohol abuse, HBV infection, and cryptogenic cirrhosis. Two of the patients with cryptic HBV infection also presented hepatocellular carcinoma. Markers of previous HBV infection were available in two patients with occult HBV infection and were negative in both. In conclusion, using a sensitive nested polymerase chain reaction assay to detect HBV DNA in frozen liver tissue, we found a low prevalence of occult HBV infection in cirrhotic patients undergoing liver transplant, probably due to the low prevalence of HBV infection in our population.

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Section: Discussionmentioning

confidence: 99%

Occult hepatitis B virus infection in liver transplant patients in a Brazilian referral center

Ferrari

Xavier

Vidigal

et al. 2014

Braz J Med Biol Res

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“…Occult HBV infection has received much attention recently, since it has been detected in patients with hepatocarcinoma [18], in blood donors and transfused patients [19,20], and in patients infected with hepatitis C virus [21][22][23]. In chronic HCV patients on hemodialysis, the prevalence of occult HBV infection is not yet well known [22,24].…”

Section: Discussionmentioning

confidence: 99%

Occult hepatitis B virus infection in immunocompromised patients

Jardim¹,

Gonçales²,

Pereira³

et al. 2008

Braz J Infect Dis

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Occult hepatitis B infection is characterized by hepatitis B virus (HBV) DNA in the serum in the absence of hepatitis B surface antigen (HBsAg). We assessed occult HBV infection prevalence in two groups of immunocompromised patients (maintenance hemodialysis patients and HIV-positive patients) presenting HBsAgnegative and anti-HBc positive serological patterns, co-infected or not by HCV. Thirty-four hemodialysis anti-HIV negative patients, 159 HIV-positive patients and 150 blood donors who were anti-HBc positive (control group) were selected. HBV-DNA was detected by nested-PCR. Occult hepatitis B infection was not observed in the hemodialysis patients group but was found in 5% of the HIV-patients and in 4% of the blood donors. Immunosuppression in HIV positive patients was not a determining factor for occult HBV infection. In addition, no significant relationship between HBV-DNA and HCV co-infection in the HIV-positive patient group was found. A lack of significant associations was also observed between positivity for HBV-DNA and CD4 count, viral load and previous lamivudine treatment in these HIV-positive patients.

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“…However, it may take many years to decrease HBV prevalence among blood donors as the vaccine is usually given to newborns, but also in some programs to adolescents and at-risk health-care workers. Pereira and colleagues reported the disappearance of HBV DNA in the serum of patients with OBI after immunization with an HBsAg vaccine; the durability of the response could not be ascertained [51]. Vaccination however may favour the development of escape mutants.…”

Section: Additional Developments To Potentially Reduce Hbv Transfusiomentioning

confidence: 99%

Transfusion-transmitted hepatitis B virus infection

Candotti

Allain

2009

Journal of Hepatology

181

155

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Hepatitis B virus (HBV) remains a major risk of transfusion-transmitted infection due to the pre-seroconversion window period (WP), infection with immunovariant viruses, and with occult carriage of HBV infection (OBI). Reduction of HBV residual risk depends upon developing more sensitive HBV surface antigen (HBsAg) tests, adopting anti-HBc screening when appropriate, and implementing HBV nucleic acid testing (NAT), either in minipools or more efficiently in individual samples. HBV NAT combines the ability to significantly reduce the window period and to detect occult HBV carriage substantiating decades of clinical observation that HBsAg-negative/anti-HBc-positive blood could transmit HBV. Clinical observations suggest limited transmission rate of occult HBV compared to WP. Low transmission rate might be related to low viral load observed in OBIs or to the presence of mutants associated with occult carriage. OBIs carrying detectable anti-HBs ( approximately 50%) are essentially not infectious by transfusion. However, recent data suggest that the neutralizing capacity of low anti-HBs may be inefficient when overcome by exposure to high viral load. Anti-HBc blood units without detectable anti-HBs appear moderately infectious except in immunocompromised recipients. Immunodeficient elderly and patients receiving immunosuppressive treatments may be susceptible to infection with lower infectious dose even in the presence of anti-HBs. The immune status of blood recipients should be taken into consideration when investigating "post-transfusion" HBV infection. Pre-transfusion testing and post-transfusion long-term follow-up of recipients, and molecular analysis of the virus infecting both donor and recipient are critical to definitively incriminate transfusion in the transmission of HBV.

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HBV vaccination of HCV-infected patients with occult HBV infection and anti-HBc-positive blood donors

Cited by 13 publications

References 28 publications

Occult hepatitis B virus infection in liver transplant patients in a Brazilian referral center

Occult hepatitis B virus infection in liver transplant patients in a Brazilian referral center

Occult hepatitis B virus infection in immunocompromised patients

Transfusion-transmitted hepatitis B virus infection

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