Lengths of hepatitis B viremia and antigenemia in blood donors: preliminary evidence of occult (hepatitis B surface antigen–negative) infection in the acute stage

Yoshikawa, Akira; Gotanda, Yuko; Minegishi, Kiyoshi; Taira, Rikizo; Hino, Satoru; Tadokoro, Kenji; Ohnuma, Hiroyuki; Miyakawa, Keiko; Tachibana, K; Mizoguchi, Hideaki

doi:10.1111/j.1537-2995.2007.01234.x

Cited by 62 publications

(91 citation statements)

References 21 publications

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“…Recently, Manzini and colleagues reported a blood donor who tested HBV NAT positive but did not develop detectable HBsAg over a period of 97 days despite anti-HBc and antiHBs seroconversion [40]. Three cases of OBI in the acute stage have been reported from the Japanese Red Cross but viral loads were >10 4 copies/mL ( J 10 3 IU/mL) and S escape mutants could not be ruled out in one of the donors [41].…”

Section: Hbv Nucleic Acid Testing (Nat)mentioning

confidence: 96%

“…This applies only to repeat donors who made more than one donation during the study period, and it may underestimate the risk as first time donors might be at greater risk of infection than repeat donors [56]. The most common approach is to measure seroconversion to HBsAg despite the rapid disappearance of this marker in a few months after infection in 95% of immunocompetent adults [41]. Therefore, a newly infected donor would not be identified as such if HBsAg is cleared from the blood between donations and true HBV infection incidence will be underestimated.…”

Section: Estimation Of Hbv Residual Transfusion Transmission Riskmentioning

confidence: 98%

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Transfusion-transmitted hepatitis B virus infection

Candotti

Allain

2009

Journal of Hepatology

191

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: Hbv Nucleic Acid Testing (Nat)mentioning

confidence: 96%

Section: Estimation Of Hbv Residual Transfusion Transmission Riskmentioning

confidence: 98%

Transfusion-transmitted hepatitis B virus infection

Candotti

Allain

2009

Journal of Hepatology

191

158

View full text Add to dashboard Cite

show abstract

“…The observed discrep- ancies could be also explained by the limitations of serological tests, considering their inability to detect HBsAg in some cases (with several molecular explanations) (20). Also, with low HBsAg expression, it is often possible to find a person undetectable by this antigen, but positive for AbHBc with a very low viral load (21)(22)(23). Consequently, sole evaluation of HBsAg may not be the optimal strategy to define the state of a carrier in a study population.…”

Section: Discussionmentioning

confidence: 99%

World Hepatitis Day in Burkina Faso, 2016: Awareness, Screening, Identification of HBV Markers, HBV/HCV Coinfection, and Vaccination

et al. 2017

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Background: Hepatitis B virus (HBV) can cause chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Coinfection with hepatitis C virus (HCV)/HBV leads to a higher risk of liver damage. Development of HBV awareness campaigns could reduce the prevalence of this disease and limit the consequences. Objectives: The aim of this study was to sensitize, detect, and identify HBV markers and propose vaccination for people not infected with HBV. Methods: With the support of "SOS Hepatitis Burkina" association, an HBV screening program, available for all volunteers, was implemented in several localities of Ouagadougou and the surroundings. A rapid HBsAg detection test was performed on 2207 subjects, who voluntarily answered a series of questions. A rapid detection test of HCV antibodies was performed in HBsAg-positive cases. HBV markers were also determined in HBsAg-positive cases.Results: In a sample of 2207 individuals, aged 1 -85 years (mean age, 31.4 ± 15.7 years), the prevalence of HBsAg was 9.8% (217/2207) after screening. Before screening, 6.8% (150/2207) of the participants claimed that they were vaccinated against HBV. Also, multivariate analysis revealed that HBV infection was significantly associated with age (21 -30 years) and vaccination status (P = 0.03; OR, 1.67; 95% CI, 1.04 to 2.69 and P = 0.003; OR, 5.69; 95% CI, 1.80 to 18.00, respectively). Among 217 HBsAg-positive cases, the prevalence of HBV markers was reported as follows: AbHBs (0.9%), HBeAg (6.0%), AbHBe (87.6%), and AbHBc (100.0%). Based on the findings, HCV was detected in 0.9% (2/217) of HBsAg-positive subjects. In this study, 628 out of 1990 HBsAg-negative subjects were vaccinated for three doses, resulting in a vaccination rate of 31.6%. Conclusions: The present study reported an HBsAg prevalence of 9.8% in the study population. This intervention could contribute to major vaccination coverage against HBV after screening. Therefore, raising awareness and development of screening campaigns on HBV can increase the vaccination coverage of the population. The findings also showed that absence of vaccination against HBV constitutes a high-risk factor for HBV infection.

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“…Nucleic acid testing (NAT) has been adopted in many OPOs as an adjunct to traditional serologic testing. NAT is extremely sensitive for active viremia and will allow safe transplantation of organs from donors with higher social and infectious risks (9). Such donors may represent up to 5% of the donor pool and may provide significant societal and recipi- ent benefits (10).…”

Section: Pancreas Transplant Patient and Allograft Survival Trendsmentioning

confidence: 99%

Kidney and Pancreas Transplantation in the United States, 1997–2006: The HRSA Breakthrough Collaboratives and the 58 DSA Challenge

Leichtman

Cohen

Keith

et al. 2008

American Journal of Transplantation

114

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Growth in the number of active patients on the kidney transplant waiting list has slowed. Projections based on the most recent 5-year data suggest the total waiting list will grow at a rate of 4138 registrations per year, whereas the active waiting list will increase at less than one-sixth that rate, or 663 registrations per year. The last 5 years have seen a small trend toward improved unadjusted allograft survival for living and deceased donor kidneys. Since 2004 the overall number of pancreas transplants has declined. Among pancreas recipients, those with simultaneous kidney-pancreas transplants experienced the highest pancreas graft survival rates. In response to the ongoing shortage of deceased donor organs, the US Health Resources and Services Administration launched the Organ Donation Breakthrough

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Lengths of hepatitis B viremia and antigenemia in blood donors: preliminary evidence of occult (hepatitis B surface antigen–negative) infection in the acute stage

Abstract: Transmission of mutant virus may cause occult HBV infection in the acute stage. HBV NAT, even in MP configuration, is more effective than HBsAg testing and capable of interdicting infected donors in the pre- and post-HBsAg window periods.

Cited by 62 publications

References 21 publications

Transfusion-transmitted hepatitis B virus infection

Transfusion-transmitted hepatitis B virus infection

World Hepatitis Day in Burkina Faso, 2016: Awareness, Screening, Identification of HBV Markers, HBV/HCV Coinfection, and Vaccination

Kidney and Pancreas Transplantation in the United States, 1997–2006: The HRSA Breakthrough Collaboratives and the 58 DSA Challenge

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