Global epidemiology of occult hepatitis B virus infections in blood donors, a systematic review and meta-analysis

Takuissu, Guy Roussel; Kenmoe, Sébastien; Atsama, Marie Amougou; Okobalemba, Etienne Atenguena; Mbaga, Donatien Serge; Ebogo‐Belobo, Jean Thierry; Bowo‐Ngandji, Arnol; Oyono, Martin Gael; Magoudjou‐Pekam, Jeannette Nina; Kame‐Ngasse, Ginette Irma; Menkem, Elisabeth Zeuko’o; Ngaloumo, Abdel Aziz Selly; Banlock, Agnès Thierry Rebecca; Feudjio, Alfloditte Flore; Zemnou-Tepap, Cromwel; Meta‐Djomsi, Dowbiss; Mviena, Gilberte Louise Nyimbe; Eloundou, Ines Nyebe; Yéngué, Jacqueline Félicité; Kenfack‐Zanguim, Josiane; Ondigui, Juliette Laure Ndzie; Mekontchou, Ridole Martin Zekeng; Touangnou-Chamda, Sabine Aimée; Takeu, Yrene Kamtchueng; Taya-Fokou, Jean Bosco; Mikangue, Chris Andre Mbongue; Kenfack‐Momo, Raoul; Kengne‐Nde, Cyprien; Esemu, Seraphine Nkie; Njouom, Richard; Ndip, Lucy

doi:10.1371/journal.pone.0272920

Cited by 10 publications

(11 citation statements)

References 39 publications

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“…The presence of anti‐HBc antibodies in 63% of HBV‐chronically infected donors' partners suggests a high proportion of previous HBV infections in this group. Additionally, 5/108 (4.6%) OBIs were identified in these 54 couples, and the prevalence of OBI was significantly higher than that in normal blood donor populations in Shenzhen (0.22%, p < 0.001) 9 or in other regions of the world (0.2%, p < 0.001), 30 indicating a high prevalence of OBI among partners of HBV chronically infected donors, which may pose a risk to blood safety. Notably, a higher prevalence of detectable HBV DNA in males may be attributable to more effective control of HBV infection in females 13 …”

Section: Discussionmentioning

confidence: 92%

The high prevalence of occult hepatitis B infections among the partners of chronically infected HBV blood donors emphasizes the potential residual risk to blood safety

Ye,

Li,

et al. 2023

Journal of Medical Virology

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A small percentage of couples who regularly donated blood in China tested positive for HBsAg. Although it is well known that blood donors can acquire hepatitis B virus (HBV) infection from a chronically infected sexual partner, the prevalence of occult hepatitis B infections (OBIs) among blood donations from partners of HBV‐infected chronically infected spouses and the risk to blood safety remain poorly understood. Among 212 763 blood donors, 54 pairs of couples (108 donations) were enrolled because one partner tested positive for HBsAg. Several molecular and serological examinations were conducted. The origin of HBV transmission between sexual partners was investigated further. Also evaluated was the potential risk of HBV infection with OBIs. We identified 10 (10/54, 18.6%) sexual partners of chronically infected HBV donors who were positive for HBV DNA, including five samples (9.3%) with OBIs, of which 3 (3/54, 5.6%, 1 in 70 921 donations) passed the routine blood screening tests. Seven of the 10 HBV‐DNA‐positive couples contracted the virus possibly through sexual or close contact. Among infected couples, immune escape mutations were observed. A high prevalence of OBIs was found among the partners of chronically infected HBV blood donors, posing a potential threat to blood safety.

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Section: Discussionmentioning

confidence: 92%

The high prevalence of occult hepatitis B infections among the partners of chronically infected HBV blood donors emphasizes the potential residual risk to blood safety

Ye,

Li,

et al. 2023

Journal of Medical Virology

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“…The diagnosis of OBI is challenging because it relies on the detection of HBV-DNA either in the liver, which requires a liver biopsy and cannot be achieved by standardized assays [ 11 ], or in plasma or serum. In OBI, HBV-DNA usually circulates at very low levels in plasma or serum, often <100 UI/mL [ 1 , 12 ], and shows fluctuations that may lead to a negative result even if highly sensitive HBV-DNA assays are employed [ 12 , 13 ]. Testing for anti-HBcs is also recommended, as those are usually detectable in all phases of the infection after the first few weeks [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…Anti-HBc positivity was identified as an independent risk factor for the development of hepatocellular cancer (HCC) [ 9 ], and most subjects with an OBI are positive for anti-HBc. On the other side, the frequency of HBV-DNA positivity in patients positive for anti-HBc and negative for HBsAg is low [ 12 , 13 ], and in some instances, a virological reactivation of HBV has also been documented in anti-HBc-positive individuals with undetectable HBsAg and HBV-DNA [ 1 ]. In recent years, efforts have been made to increase the sensitivity of HBsAg assays to allow a better detection of active HBV infection, and assays of the latest generation can detect 0.005 IU/mL of HBsAg, which has been estimated to correspond to 30–40 IU/mL of HBV-DNA [ 6 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

Occult HBV Infection in Patients Infected by HIV or HCV: Comparison between HBV-DNA and Two Assays for HBsAg

Meschi,

Mizzoni,

Leoni

et al. 2024

Viruses

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We investigated the frequency and serological correlates of occult hepatitis B virus infection (OBI) and the potential impact of a highly sensitive assay for HBsAg in subjects infected by human immunodeficiency virus (HIV) or hepatitis C virus (HCV), who are also at risk for hepatitis B virus (HBV) infection, often in an occult form. Samples from 499 patients with HIV, all HBsAg negative and anti-HBc positive, and 137 patients with HCV were tested for HBV-DNA, anti-HBc, anti-HBs, and HBsAg by a conventional and highly sensitive assay. HBV biomarkers were detected in 71.5% of HCV-RNA-positive, with a higher prevalence of cases positive only for anti-HBc in patients with HCV than in those with HIV. HBV-DNA was detectable in 0.6% of HIV-positive and 7.3% of HCV-RNA-positive patients. Among patients with HCV, four were positive for HBsAg and negative for HBV-DNA, bringing the rate of HBV-active infection in this group to 10.2%. Active HBV infection was not related to gender or specific patterns of HBV biomarkers but was higher in HCV patients coinfected by HIV compared to those infected only by HCV. Monitoring patients at high risk for HBV infection and reactivation may require testing for both HBV-DNA and HBsAg.

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“…The latter has clinical significance, as it may cause liver disease and lead to the development of liver cirrhosis and hepatocellular carcinoma (HCC) [ 28 ]. It also has implications for virus transmission, especially in transfusion scenarios [ 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

Post-Vaccination and Post-Infection Immunity to the Hepatitis B Virus and Circulation of Immune-Escape Variants in the Russian Federation 20 Years after the Start of Mass Vaccination

et al. 2023

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A neonatal vaccination against the Hepatitis B virus (HBV) infection was initiated in Russia 20 years ago, with catch-up immunization for adolescents and adults under the age of 60 years launched in 2006. Here, we have assessed the humoral immunity to HBV in different regions of Russia, as well as the infection frequency following 20 years of a nationwide vaccination campaign. We have also evaluated the role of immune-escape variants in continuing HBV circulation. A total of 36,149 healthy volunteers from nine regions spanning the Russian Federation from west to east were tested for HBV surface antigen (HBsAg), antibodies to HBV capsid protein (anti-HBc), and antibodies to HBsAg (anti-HBs). HBV sequences from 481 chronic Hepatitis B patients collected from 2018–2022 were analyzed for HBsAg immune-escape variants, compared with 205 sequences obtained prior to 2010. Overall, the HBsAg detection rate was 0.8%, with this level significantly exceeded only in one study region, the Republic of Dagestan (2.4%, p < 0.0001). Among the generation vaccinated at birth, the average HBsAg detection rate was below 0.3%, ranging from 0% to 0.7% depending on the region. The anti-HBc detection rate in subjects under 20 years was 7.4%, indicating ongoing HBV circulation. The overall proportion of participants under 20 years with vaccine-induced HBV immunity (anti-HBs positive, anti-HBc negative) was 41.7% but below 10% in the Tuva Republic and below 25% in the Sverdlovsk and Kaliningrad regions. The overall prevalence of immune-escape HBsAg variants was 25.2% in sequences obtained from 2018–2022, similar to the prevalence of 25.8% in sequences collected prior to 2010 (p > 0.05). The population dynamics of immune-escape variants predicted by Bayesian analysis have remained stable over the last 20 years, indicating the absence of vaccine-driven positive selection. In contrast, the wild-type HBV population size experienced a rapid decrease starting in the mid-1990s, following the introduction of mass immunization, but it subsequently began to recover, reaching pre-vaccination levels by 2020. Taken together, these data indicate that it is gaps in vaccination, and not virus evolution, that may be responsible for the continued virus circulation despite 20 years of mass vaccination.

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Global epidemiology of occult hepatitis B virus infections in blood donors, a systematic review and meta-analysis

Cited by 10 publications

References 39 publications

The high prevalence of occult hepatitis B infections among the partners of chronically infected HBV blood donors emphasizes the potential residual risk to blood safety

The high prevalence of occult hepatitis B infections among the partners of chronically infected HBV blood donors emphasizes the potential residual risk to blood safety

Occult HBV Infection in Patients Infected by HIV or HCV: Comparison between HBV-DNA and Two Assays for HBsAg

Post-Vaccination and Post-Infection Immunity to the Hepatitis B Virus and Circulation of Immune-Escape Variants in the Russian Federation 20 Years after the Start of Mass Vaccination

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