Anti-hepatitis B core antigen testing with detection and characterization of occult hepatitis B virus by an in-house nucleic acid testing among blood donors in Behrampur, Ganjam, Orissa in southeastern India: implications for transfusion

Panigrahi, Rajesh; Biswas, Avik; Datta, Sibnarayan; Banerjee, Arup; Chandra, Partha K.; Mahapatra, Pradip Kumar; Patnaik, Bharat Bhusan; Chakrabarti, Sekhar; Chakravarty, Runu

doi:10.1186/1743-422x-7-204

Cited by 55 publications

(46 citation statements)

References 35 publications

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“…Occult HBV during the non-replicative phase has been found to be more frequent in areas where genotypes A, D, and E are prevalent rather than genotypes B and C [4,21]. Our report is in accordance with an earlier report [5] from India that revealed HBV/D as the prevalent genotype among OBI cases.…”

Section: Discussionsupporting

confidence: 83%

“…The present study revealed OBI in 10.1% of individuals belonging to the Nicobarese tribe. Varying prevalence of anti-HBc, a marker for exposure to HBV infection, has been reported from different parts of India, ranging between 8% and 18% [5]. Prevalence of occult HBV infection was also high among the anti-HBc positive individuals belonging to the vaccinated and non-vaccinated cohorts from the present study; 64.5% (40/62) of antiHBc-positive cases were HBV DNA positive.…”

Section: Discussionmentioning

confidence: 50%

“…The frequency of occult HBV infection varies considerably from different parts of the world according to the prevalence of HBV in the population [5]. Studies from other parts of India reported occult HBV infection ranging from 21% in Kolkata (eastern India), 20.87% in New Delhi (northern India) to 0% in Chandigarh (north-western India) [18][19][20].…”

Section: Discussionmentioning

confidence: 99%

“…Occult HBV infection (OBI) is defined as the presence of circulating HBV DNA in the absence of serologically detectable hepatitis B surface antigen (HBsAg negative) [3][4][5]. The HBV DNA may be present in patients with serological markers of previous infection (anti-HBc and/or anti-HBs positive) or in patients without serological markers (anti-HBc and/or anti-HBs negative).…”

Section: Introductionmentioning

confidence: 99%

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Occult hepatitis B infection among individuals belonging to the aboriginal Nicobarese tribe of India

Bhattacharya

Roy

et al. 2014

J Infect Dev Ctries

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Introduction: The long-lasting persistence of hepatitis B virus (HBV) genomes in the liver (with or without detectable HBV DNA) of individuals with negative for HBV surface antigen (HBsAg) is termed occult HBV infection (OBI). The present study is a part of the follow up on efficacy of vaccination, 10 years post inception, and was designed to understand the prevalence of Occult Hepatitis B infection (OBI) among the aboriginal Nicobarese tribal community. Methodology: A total of 612 serum samples were collected and tested for various markers including HBsAg, Anti-HBs, Anti-HBc and HBV DNA. Part of S gene of the extracted HBV DNA was amplified by nested PCR. The amplified products were then subjected to sequencing. Genotyping was performed on the basis of phylogenetic relationship along with representative reference sequences from different sub genotypes. Results: The study revealed OBI in 11.1% of the people belonging to the Nicobarese tribe. Phylogenetic analysis showed only one genotype, HBV/D circulating among the Nicobarese population with ayw3 was the major serotype detected. Single or multiple amino acids substitutions were found in 5 of 34 samples (14.7%) which includes I110T, P120T, P/T127I, A128P, M133L and G159V. Conclusions: The detection of OBI among these aboriginal tribes is of great concern and stresses the need for the continuous surveillance as it may contribute to the progression of liver disease to a more advanced stage.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Occult hepatitis B infection among individuals belonging to the aboriginal Nicobarese tribe of India

Bhattacharya

Roy

et al. 2014

J Infect Dev Ctries

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“…The highest yield was for HBV infection (6/8) [9]. There are a few other reports from India [10][11][12][13][14][15] which also show that the addition of tests to detect nucleic acids (NAT or PCR) increased the yield of donors who are hepatitis B positive. In China and Taiwan, with a high endemicity of hepatitis B, the addition of NAT increased the detection of occult carriers [16,17].…”

mentioning

confidence: 99%

Into the occult: Strategies for preventing transfusion-transmissible infections

Mathan¹

2013

Indian J Gastroenterol

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Transfusion services all over the world are constantly trying to improve blood safety and to reduce the residual risk of transfusion-transmissible infections (TTI). Current mandatory tests to detect TTI in India include testing for human immunodeficiency virus 1 and 2 antibodies, hepatitis B surface antigen (HBsAg), hepatitis C virus antibodies, syphilis, and malaria. Studies from Europe and America suggest that the addition of nucleic acid testing (NAT) will increase the detection rate of the transmissible viral infections, thereby increasing safety of blood transfusion [1][2][3][4][5][6]. In India, NAT is not mandatory although several major blood banks have already included this in their screening profile.The article by Sodhi et al. [7] in this issue of the Journal highlights this question. Six percent of their 150 patients who had multiple transfusions developed evidence of hepatitis B virus infection, with seven of the nine patients developing clinical viral hepatitis. The authors showed that testing stored serum samples from the blood donor for antihepatitis B core (HBc) antibody and HBV DNA quantitation by realtime polymerase chain reaction (PCR) detected HBV infection in six of the nine donors. HBV DNA was detected in four of them; the two others having only IgG anti-HBc. In the other three patients, they concluded that the source of hepatitis B infection was other than the transfusion. The prevalence of HBsAg in healthy blood donors, as reported in their paper was 0.56 %.Sensitivity and specificity of the currently used fourthgeneration enzyme-linked immunosorbent assays are much better than the earlier versions but it is clear that they fail to detect donors in the window period and with occult infections without detectable levels of circulating HBsAg. It has been suggested that the addition of anti-HBc testing may be a costeffective strategy, though there have been reports of occult infection in anti-HBc-negative individuals. Therefore, without NAT testing, the addition of anti-HBc as a routine practice would only lead to a higher rate of discard of blood units as the rate of anti-HBc positivity in blood donors is 10 %-20 % [8].There are excellent research studies and detailed reviews [1-6] from Europe and America which clearly showed that the addition of NAT increased the rate of detection of viral infections in potential donors. NAT is now mandatory in screening potential donors in many of these countries. From India, a detailed multicentre evaluation of NAT was published in 2008 involving eight large blood banks from metropolitan centers [9]. It was reported that eight additional infected donors were detected out of a total 12,224 samples. The highest yield was for HBV infection (6/8) [9]. There are a few other reports from India [10][11][12][13][14][15] which also show that the addition of tests to detect nucleic acids (NAT or PCR) increased the yield of donors who are hepatitis B positive. In China and Taiwan, with a high endemicity of hepatitis B, the addition of NAT increased the detection of o...

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Comprehensive analysis of the prevalence of hepatitis B virus escape mutations in the major hydrophilic region of surface antigen

Wang

2011

Journal of Medical Virology

115

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Escape mutations in the major hydrophilic region (MHR) of hepatitis B surface antigen (HBsAg) are reported widely worldwide; these mutations lead to diagnostic problems, emergence of vaccine-escape mutants, and hepatitis B immunoglobulin (HBIG) therapy failure. However, the prevalence of these mutations in different genotypes remains to be studied systematically. In the current study, 11,221 non-redundant hepatitis B virus (HBV) sequences of 8 genotypes (from A to H), obtained from the National Center for Biotechnology Information (NCBI), were analyzed to determine the prevalence of HBsAg escape mutations that were previously described. Eight important mutations associated with diagnostic failure, P120T, T126S, Q129H, G130N, S143L, D144A, and G145A/R, were prevalent in one or more genotypes, with the frequency of no less than 1%. With regard to escape variants that evade vaccine or immunoglobulin therapy, mutations were located mainly at positions 120, 126, 129, 130, 133, 134, 137, 140, 143, 144, and 145. The majority of such mutations showed genotypic heterogeneity, indicating the different distribution of the escape mutations. Most of the escape mutations clustered in the "a" determinant, indicating that this region was more likely to be affected by immune selection or antiviral therapy than other regions. Understanding the prevalence and heterogeneity of escape mutations could provide useful guidance for the improvement of diagnostic assays, design of new vaccines, and prevention of failure of HBIG therapy.

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Anti-hepatitis B core antigen testing with detection and characterization of occult hepatitis B virus by an in-house nucleic acid testing among blood donors in Behrampur, Ganjam, Orissa in southeastern India: implications for transfusion

Cited by 55 publications

References 35 publications

Occult hepatitis B infection among individuals belonging to the aboriginal Nicobarese tribe of India

Occult hepatitis B infection among individuals belonging to the aboriginal Nicobarese tribe of India

Into the occult: Strategies for preventing transfusion-transmissible infections

Comprehensive analysis of the prevalence of hepatitis B virus escape mutations in the major hydrophilic region of surface antigen

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