Post-Transfusion Occult Hepatitis B (OBI): A Global Challenge for Blood Recipients and Health Authorities

Abstract

Hepatitis B is one of the most frequent post-transfusion infections. Occult hepatitis B infection (OBI) is a form of hepatitis B infection in which, despite the presence of HBV-DNA in the serum and hepatocytes of the carrier, HBsAg is absent. In addition to the risk of transmission through the transfusion of infected blood, reactivation of hepatitis B in OBI patients and recipients of their blood can lead to cirrhosis, hepatic cancer, and reactivation of viral replication in the carrier. Therefore, effective assays to assess and screen for OBI in blood donors are of paramount importance and require urgent attention. Recently, several investigations in various regions of Iran have reported OBI in blood donors. In response, there has been a drive to apply more specific, sensitive, and accurate methods for the detection of HBV, which should become an obligatory screening process for all blood transfusion services. In this review, we address the progression of occult hepatitis B and the common problems associated with occult hepatitis B worldwide. Finally, we reflect on the research and screening that is being performed in Iran to deal with this problem.

Occult Hepatitis B Infection in Hepatitis C Patients with Hematological Disorders

“…Because of the particular diagnostic tests for OBI, it is not diagnosed during common screening in blood transfusion centers and can therefore be transmitted via transfusion of infected blood or blood components and induce post transfusion hepatitis (PTH) (27,28). These conditions should be considered among patients who need permanent transfusions of blood, as in the case of hemophilia, thalassemia and hemodialysis patients (29,30). In addition, OBI is observed more frequently in patients with CHC infection.…”

Molecular identification of hepatitis B virus genotypes/subgenotypes: Revised classification hurdles and updated resolutions

“…In Bolivia, the exchange of native HBV subgenotype F4 and exotic ones (subgenotypes B2 and C2) between Bolivian and Japanese immigrants was clearly demonstrated by phylogenetic analysis [151] . Interestingly, the exotic strains have different mutational patterns in different ORFs of HBV [123] , which would have a different impact on the course of infection, therapeutic, diagnostic and prophylactic measures [152,153] .…”

Characteristics of escape mutations from occult hepatitis B virus infected patients with hematological malignancies in South Egypt

“…Therefore, patients with hematological malignancies might be more likely to develop occult HBV infections than those without. The highest prevalence of occult HBV was reported in patients with hepatocellular carcinoma (62.5%; 25/40) in tissue samples[8,31]. …”

“…HBV reactivation is a well-known complication in patients with occult infection under immune suppression, such as anticancer therapy, and human immunodeficiency virus (HIV) infection[6,7]. In addition, occult HBV infection increases the risk of HBV transmission through blood transfusion[8]. …”