Detection of hepatitis C virus (HCV) core–specific antibody suggests occult HCV infection among blood donors

Abstract

BACKGROUNDBlood transfusion safety is based on reliable donor screening for transmissible infections such as the hepatitis C virus (HCV) infection.STUDY DESIGN AND METHODSA novel HCV core–specific antibody was assayed on random single donations from 2007 first‐time blood donors who tested negative for anti‐HCV and HCV RNA on routine screening. Sample collection broke the code between donations and donors for ethical reasons.RESULTSForty‐two donations (2.1%) displayed reactivity in the novel test. The specificity of the reactivity was evaluated by a peptide inhibition assay, and testing against additional nonoverlapping HCV core peptide epitopes and other HCV antigens was performed on these samples. Six donations (14.3%; 0.30% from the total) were considered to contain anti‐HCV after such supplemental testing. HCV RNA detection was also performed in peripheral blood mononuclear cells (PBMNCs) and serum or plasma samples from reactive donors after virus concentration by ultracentrifugation. HCV RNA tested negative in all PBMNCs samples, and a very low amount of viral genome was detected in serum or plasma concentrates from three anti‐HCV core–reactive donors (7.1%) but not among concentrates from 100 randomly selected nonreactive donors. Sequencing of these polymerase chain reaction products revealed differences between the isolates that excluded partially sample contamination from a common source.CONCLUSIONThese findings argue in favor of an ongoing occult HCV infection among these blood donors and account for some rather low, but perhaps not negligible, infection risk for such donations. Future studies involving larger samples of donations from traceable donors would enlighten the significance of these findings for the viral safety of the blood supply.

Anti‐HCV immunoblot indeterminate results in blood donors: non‐specific reactivity or past exposure to HCV?

“…The significance of IB indeterminate results in blood donors without detectable HCV RNA can be difficult to determine and possible interpretations include resolved HCV infection where antibodies to some HCV antigens are no longer detectable due to declining levels (partial seroreversion) or were never detectable; infection with a genotype different to that used to derive the immunoblot antigens resulting in reduced assay sensitivity ; an indicator of early seroconversion when fluctuating RNA levels may become temporarily undetectable ; occult HCV infection where HCV RNA is detectable in hepatocytes and/or peripheral blood mononuclear cells but not in the blood ; or non‐specific reactivity .…”

Prevalence of Occult Hepatitis C Virus Infection among Blood Donors in Jiangsu, China

“…This indicated that OCI would persist long after the spontaneous resolution of hepatitis C at levels undetectable by current testing. In a more recent investigation [30], 2.1% (42/2,007) of blood donations displayed reactivity in a novel HCV-core specific antibody assay. In core reactive samples, 6 blood donors had HCV RNA in their PBMCs, serum, and plasma by ultracentrifugation, and 3 had HCV RNA in their serum and plasma.…”

Occult Hepatitis C Virus in Blood Donors in Damietta - Egypt

“…This result closed to other investigation of Shazly et al (2015) [21] who documented that OCI was 4% in healthy Egyptian individual partners of patients infected with chronic HEPATITIS C VIRUS genotype 4 infection. Also in hemodialysis patients Abdurrahman et al (2016) [22] detect OCI (3.7%) in 81 at Mania-Egypt, Also Maria de la Luz Martinez-Rodríguez 2018 [23] in Mexico City documented OCI 3.4% in blood donors Samples, Lin H 2016 documented OCI 2.2%in China [24] and Quinoa JA 2016 OCI is 2.1% Spain [25].…”