Occult hepatitis B infection in blood donors

Identification of low HBV-DNA levels by nucleic acid amplification test (NAT) in blood donors

“…Nevertheless, further investigation of the pathogenic role of very low HBV-DNA levels in blood donations is necessary, in particular for children and immunocompromised persons, in whom acute HBV infection may be severe. 3,5,12,16,19 In blood donors with serological markers of past HBV infection and very low HBV-DNA levels, the results of liver function tests performed prior to transfusion were within normal ranges (data not shown), and no risk of liver disease was reported for these individuals. However, the use of ALT and HBV-DNA levels to define an inactive carrier state or ''occult'' infection may not be sufficient for the histological diagnosis of liver disease.…”

Low Prevalence of Occult Hepatitis B Infection Among Blood Donors in Beirut, Lebanon: Reconsider the Deferral Strategy of Anti-HBc Positive Blood Donors

“…Occult HBV infection (OBI) was defined by an international workshop held in 2008 as the "presence of HBV DNA in liver (with a viral load of < 200 IU/mL or undetectable HBV DNA in the serum) of individuals testing hepatitis B surface antigen negative by currently available assays" (6)(7)(8). The prevalence of OBI carriers was shown to be more prominent since the introduction of HBV DNA nucleic acid testing (NAT) in blood transfusion centers across all continents with yield varying from 0.1% to 4.16% (2)(3)(4)(5)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22).…”

Clearance of serum HBsAg and anti‐HBs seroconversion following antiviral therapy for chronic hepatitis B

“…This confirms the results of previous studies suggesting that serum HBsAg levels do no correlate directly with viral replication, but rather reflect the pool of infected hepatocytes producing viral antigens and may be an indirect marker of intrahepatic cccDNA the template for viral protein expression [Pichoud et al, 2000;Werle-Lapostolle et al, 2004;Wursthorn et al, 2006b;Lutgehetmann et al, 2008]. However, the clearance of serum HBsAg may not reflect the complete cure of HBV infection since cccDNA and integrated viral genome may persist in the liver after HBsAg seroconversion [Pollicino et al, 2004;Werle-Lapostolle et al, 2004] as well as low level occult viremia [Reesink et al, 2008].…”