Individual nucleic amplification technology does not prevent all hepatitis B virus transmission by blood transfusion

Inaba, Shinji; Itō, Akira; Miyata, Yusuke; Ishii, Hiroyuki; Kajimoto, Shoko; Tanaka, Masatsugu; Maruta, Atsuo; Saito, Satoru; Yugi, Hisao; Hino, Minabu; Tadokoro, Kenji

doi:10.1111/j.1537-2995.2006.01011.x

Cited by 34 publications

(46 citation statements)

References 3 publications

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“…However, in some cases, units from WP and OBI donors were not infectious even though viral load ranging between <20 and >500 IU/mL (<100 and >2500 geq/ml) was transfused [31,[88][89][90]. The lack of clear relationship between infectivity and viral load in blood components may be related to immune factors affecting the susceptibility to infection in recipients as discussed below.…”

Section: Determining the Hbv Infectious Dose(s)mentioning

confidence: 88%

“…In humans, HBV transmission was reported from donors in the WP and OBI donors showing HBV DNA load <20 IU/mL (Table 2) [42,88,89]. However, in some cases, units from WP and OBI donors were not infectious even though viral load ranging between <20 and >500 IU/mL (<100 and >2500 geq/ml) was transfused [31,[88][89][90].…”

Section: Determining the Hbv Infectious Dose(s)mentioning

confidence: 90%

“…Inaba and colleagues reported three of four cases of acute hepatitis B and two suspected seroconversions that were not recognized by local physicians as being related to transfusion [88]. Twenty UK cases of hepatitis B associated with presumably infectious donors were identified (but only four were confirmed) over the past 15 years, none of which were suspected by local physicians in a timely fashion [93].…”

Section: Diagnosis Of Transfusion-transmitted Hbvmentioning

confidence: 97%

“…Evidence of transfusion transmission of HBV may not be obtained because pre-transfusion samples are rarely available, HBV infections might have resolved before they are identified by lookback, and often recipients cannot be traced or samples obtained [63]. As HBV marker levels may fluctuate over time [47,88], follow-up of suspected donors and testing of archived samples are necessary to exclude recent infection and false-positive [106,107,119]. Testing for archived donations and recipient samples requires access to a frozen repository of donor/recipient samples.…”

Section: Diagnosis Of Transfusion-transmitted Hbvmentioning

confidence: 98%

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Transfusion-transmitted hepatitis B virus infection

Candotti

Allain

2009

Journal of Hepatology

184

158

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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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Section: Determining the Hbv Infectious Dose(s)mentioning

confidence: 88%

Section: Determining the Hbv Infectious Dose(s)mentioning

confidence: 90%

Section: Diagnosis Of Transfusion-transmitted Hbvmentioning

confidence: 97%

Section: Diagnosis Of Transfusion-transmitted Hbvmentioning

confidence: 98%

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Transfusion-transmitted hepatitis B virus infection

Candotti

Allain

2009

Journal of Hepatology

184

158

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“…A recent study of OBI in Asian blood donors showed a viral load range between unquantifiable and 3670 IU/mL with a median 11 IU/ mL [49] . In humans, HBV transmission was reported from donors in the window period and OBI donors showing HBV DNA load < 20 IU/mL [7,34,50] . There is preliminary evidence that immunocompromised patients are not only more susceptible to lower infectious dose in the presence of anti-HBs but also at higher risk of developing chronic infection [51] .…”

mentioning

confidence: 99%

Occult hepatitis B virus infection among Egyptian blood donors

Said

Sayed²,

Salama

et al. 2013

WJH

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AIM:To identify blood donors with occult hepatitis B virus (HBV) infection (OBI) to promote safe blood donation. METHODS:Descriptive cross sectional study was conducted on 3167 blood donors negative for hepatitis B surface antigen (HBsAg), hepatitis C antibody (HCV Ab) and human immunodeficiency virus Ab. They were subjected to the detection of alanine aminotransferase (ALT) and aspartate transaminase (AST) and screening for anti-HBV core antibodies (total) by two different techniques; [Monoliza antibodies to hepatitis B core (Anti-HBc) Plus-Bio-Rad] and (ARC-HBc total-ABBOT). Positive samples were subjected to quantitative detection of antibodies to hepatitis B surface (anti-HBs) (ETI-AB-AUK-3, Dia Sorin-Italy). Serum anti-HBs titers > 10 IU/L was considered positive. Quantitative HBV DNA by real time polymerase chain reaction (PCR) (QIAGEN-Germany) with 3.8 IU/mL detection limit was estimated for blood units with negative serum anti-HBs and also for 32 whose anti-HBs serum titers were > 1000 IU/L. Also, 265 recipients were included, 34 of whom were followed up for 3-6 mo. Recipients were investigated for ALT and AST, HBV serological markers: HBsAg (ETI-MAK-4, Dia Sorin-Italy), anti-HBc, quantitative detection of anti-HBs and HBV-DNA. RESULTS: 525/3167 (16.6%) of blood units were positive for total anti-HBc, 64% of those were antiHBs positive. Confirmation by ARCHITECT anti-HBc assay were carried out for 498/525 anti-HBc positive samples, where 451 (90.6%) confirmed positive. Reactivity for anti-HBc was considered confirmed only if two positive results were obtained for each sample, giving an overall prevalence of 451/3167 (14.2%) for total anti-HBc. HBV DNA was quantified by real time PCR in 52/303 (17.2%) of anti-HBc positive blood donors (viral load range: 5 to 3.5 x 10 5

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Durch Blut übertragbare Infektionskrankheiten

Caspari¹,

Gerlich

2010

Transfusionsmedizin Und Immunhämatologie

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Individual nucleic amplification technology does not prevent all hepatitis B virus transmission by blood transfusion

Cited by 34 publications

References 3 publications

Transfusion-transmitted hepatitis B virus infection

Transfusion-transmitted hepatitis B virus infection

Occult hepatitis B virus infection among Egyptian blood donors

Durch Blut übertragbare Infektionskrankheiten

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