Hepatitis B virus infection and transfusion medicine: science and the occult

Hollinger, F. Blaine

doi:10.1111/j.1537-2995.2008.01701.x

Cited by 176 publications

(203 citation statements)

References 134 publications

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“…. The presence of anti-HBs and anti-HBc is usually indicative of immunity after infection. In some countries such as Germany, Austria and Japan, blood units with antiHBs levels greater than 100 IU/L is considered to be safe [26]. However, there was evidence that transmission of HBV from occult hepatitis B subjects occurred in the presence of concurrent neutralizing anti-HBs in the same specimen [28].…”

Section: Discussionmentioning

confidence: 96%

“…In this study, HBV DNA was detected in 25 (18.7%) of anti-HBcpositive regular blood donors with higher frequency of HBV DNA in isolated anti-HBc subjects than in those with anti-HBc and anti-HBs. This finding highlights the importance of anti-HBc compared to other serological HBV markers for predicting latent HBV infection in apparently healthy individuals, and reiterates that the implementation of anti-HBc screening would improve the safety of blood supply [25][26][27]. However, in highly endemic regions including Indonesia, anti-HBc screening would be impractical due to the high loss of potential donors (approximately, 70% of isolated anti-HBc donors).…”

Section: Discussionmentioning

confidence: 99%

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Occult hepatitis B in blood donors in Indonesia: altered antigenicity of the hepatitis B virus surface protein

et al. 2010

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Background and aims Occult hepatitis B virus infection (OBI) poses a challenge to the safety of blood donation. The prevalence of OBI is not well documented in Indonesia, although this information in such an endemic country is needed. This study was aimed to evaluate the prevalence of occult hepatitis B in blood donors from two cities of Indonesia, and to study the genetic variation and its effect on the predicted antigenicity of HBsAg. Methods Serum samples of 309 regular blood donors negative for HBsAg were tested for anti-HBs and antiHBc. Hepatitis B virus (HBV) DNA isolated from antiHBc-positive samples were analyzed by polymerase chain reaction, cloned and sequenced. Antigenic properties of identified HBsAg mutants were predicted by calculation of the antigenic index. Results Of the 309 HBsAg-negative samples, anti-HBc was positive in 134 (43.4%) and HBV DNA was detected in 25 (8.1%). Seven of the viremic samples had nucleotide substitutions (A521G, A551T, C582T, and A562G) in the S gene, causing amino acid mutations (T123A, M133L, and T143M) in the 'a' determinant of HBsAg that resulted in changes in the predicted antigenicity. Conclusions OBI was detected in blood donors' samples in Indonesia. Anti-HBc was shown to be a better screening parameter than HBsAg, however, it might result in the loss of donors particularly in endemic countries. HBsAg detection failure in this study might be due to mutations altering the protein antigenicity and/or the low-level carriage of HBV.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Occult hepatitis B in blood donors in Indonesia: altered antigenicity of the hepatitis B virus surface protein

et al. 2010

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“…However, the true prevalence of HBV could be underestimated due to the presence of OHB cases. 12,13,18 When this situation is applied in blood banking, the high OHB prevalence might consequently cause the release of infectious blood units to recipients.…”

Section: Discussionmentioning

confidence: 99%

“…However, its results are often in disagreement with the serological results. [11][12][13] Such discrepancies are of public health significance, since HBV DNA is detected alongside HBsAg-negative serological profiles that are previously considered to be noninfectious, including isolated anti-HBc and seronegative samples. [14][15][16][17] Commonly, low HBV DNA titer is detectable in these samples, classifying them as occult hepatitis B (OHB).…”

Section: Introductionmentioning

confidence: 99%

High Prevalence of Hepatitis B Virus Infection in Young Adults in Ternate, Eastern Indonesia

Ie¹,

Turyadi²,

Sidarta³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. The incidence of hepatitis B virus (HBV) infection has been declining thanks to the universal hepatitis B infant immunization program. Nevertheless, young adults born before the program implementation might have acquired HBV in early childhood or remain susceptible to infection. This study aimed to evaluate hepatitis B epidemiology in asymptomatic young adult population in Ternate, eastern Indonesia. Serum samples of 376 subjects (aged 17-25, mean 19.82 ± 1.69 years; male/female 138/238) were screened for HBV parameters serologically (HBV surface antigen [HBsAg]; its antibody [anti-HBs]; anti-core antigen [anti-HBc]), and molecularly (HBV DNA). HBsAg, anti-HBc, anti-HBs, and HBV DNA prevalence were 15.7%, 36.2%, 24.2%, and 27.9%, respectively, with male predominance. Of all subjects, 13.0% were HBsAg negative with detectable HBV DNA (occult hepatitis B [OHB]), and 56.4% showed negativity for all seromarkers. This population showed high hepatitis B prevalence with substantial occurrence of OHB. However, a high percentage of the population were still susceptible and at risk of HBV infection. This study emphasizes the necessity to improve prevention strategies to screen and manage HBV carriers, including the adoption of catch-up or booster vaccination targeted to young adult populations. Investigations on the roles of host-virus interactions associated with OHB and its implications are warranted.

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“…Algunos investigadores consideran que la presencia de HBeAg, o más frecuentemente anti-HBe, puede confirmar el valor de anti-HBc en la detección de exposición (27). La hepatitis B oculta puede observarse en pacientes con infección crónica por virus de la hepatitis B con reactividad para el anti-HBc; esto sucede por el declive del HBsAg a un nivel indetectable, algunas veces asociado a la aparición del anti-HBs.…”

Section: Interpretaciónunclassified

Detección de hepatitis B oculta en donantes de bancos sangre, Colombia 2008-2009

et al. 2011

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Palabras clave: transfusión sanguínea, hepatitis B, bancos de sangre. Colombia. Absence of occult hepatitis B in Colombian blood donorsIntroduction. In Colombian blood banks, screening for the surface antigen of hepatitis B is mandatory in all units collected. Testing of antibody against core antigens is not administered, although this method may be useful to detect donors infected with the hepatitis B virus. Objective. The prevalence of occult hepatitis B was determined by applying a full-serological profile of hepatitis B virus to blood samples of blood donors. Materials and methods. Between April 2008 and October 2009, a prospective cross sectional study was conducted using 628 samples from donors to blood banks located in four Colombian cities. Prevalence for hepatitis B had been previously recorded for these cities. Serological screening was performed for the complete virus; then nucleic acid amplification was tested in sera that were anti-HBc reactive and with a titer of anti-HBs ≤30 mUI/ml. Results. Of the 628 samples tested, 129 met the serological criteria established to be tested nucleic acid amplification. None of them demonstrated evidence of nucleic acid amplification of hepatitis B virus. Conclusions. This is the first study in Colombia to detect the presence of blood donors that may be occult hepatitis B carriers. None was detected.

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Hepatitis B virus infection and transfusion medicine: science and the occult

Cited by 176 publications

References 134 publications

Occult hepatitis B in blood donors in Indonesia: altered antigenicity of the hepatitis B virus surface protein

Occult hepatitis B in blood donors in Indonesia: altered antigenicity of the hepatitis B virus surface protein

High Prevalence of Hepatitis B Virus Infection in Young Adults in Ternate, Eastern Indonesia

Detección de hepatitis B oculta en donantes de bancos sangre, Colombia 2008-2009

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