Prevalence of markers of hepatitis B in the adult German population

Jilg, Wolfgang; Hottenträger, Barbara; Weinberger, Klaus M.; Schlottmann, Klaus; Frick, E; Holstege, Axel; Schölmerich, Jürgen; Palitzsch, Klaus‐Dieter

doi:10.1002/1096-9071(20000201)63:2<96::aid-jmv1002>3.3.co;2-3

Cited by 17 publications

(24 citation statements)

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“…In previous studies in unselected hospital populations and in the adult German population, subjects with Ôanti-HBc aloneÕ and HBV-DNA in serum were all reported to have viral loads below 10 4 copies/mL [12,34,35]. In HIV-infected patients with HBV-DNA positivity in the absence of detectable HBs antigenaemia, viral loads also rarely reached 350 IU/mL [41].…”

Section: Discussionmentioning

confidence: 99%

High levels of serum hepatitis B virus DNA in patients with ‘anti-HBc alone’: role of HBsAg mutants

Launay

Masurel

Servant‐Delmas

et al. 2011

Journal of Viral Hepatitis

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It remains unclear how the detection of hepatitis B core antibody (anti-HBc) in the absence of hepatitis B surface antigen (HBsAg) and antibody (anti-HBs) should be interpreted and whether all patients with this pattern need to be tested for hepatitis B virus (HBV)-DNA. This study aimed at reassessing the significance of 'anti-HBc alone' in unselected sera referred to the clinical laboratory and determining whether significant HBV viraemia can be found in this setting. Of the 6431 patients tested for HBsAg, total anti-HBc and anti-HBs in a Paris hospital over a 1-year period, 362 (5.6%) had 'anti-HBc alone' (24.8% of anti-HBc-positive patients). Only 11 of the 362 sera (3.0%) were found to be false positive. One patient was in the resolving phase of acute hepatitis B. HBV-DNA was detected in 10 of 362 (2.8%) patients, using a commercial standardized assay (threshold: 350 IU/mL). Viral loads exceeded 10(4) copies/mL in 6 of 10 patients. Mutations in the HBsAg immunodominant region were identified in seven of the viraemic patients. HBsAg was detected in only two cases when retested by one of the latest, multivalent assays. Neither human immunodeficiency virus nor hepatitis C virus serostatus distinguished between patients with and without HBV-DNA. In conclusion, 'anti-HBc alone' should be considered a risk marker for a so-called 'false occult' HBV infection with significant viraemia. Indeed, results in this hospital population indicate that a small proportion of patients with 'anti-HBc alone' have high viral loads, revealing the occurrence of infection with HBV mutants that escape detection even by multivalent HBsAg assays.

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Section: Discussionmentioning

confidence: 99%

High levels of serum hepatitis B virus DNA in patients with ‘anti-HBc alone’: role of HBsAg mutants

Launay

Masurel

Servant‐Delmas

et al. 2011

Journal of Viral Hepatitis

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“…Weinberger et al [46] < 1 × 10 4 geq (median 5·0 × 10 2 ) Grethe et al [37] 1 × 10 2 −1 × 10 3 geq Yotsuyanagi et al [31] < 1 × 10 3 geq Hennig et al [13] 1000, 15, 5 IU Jilg et al [68] 100-10 000 copies Kessler et al [67] 400-4 × 10 5 copies (median 7·0 × 10 3 ) Weber et al a [69] 8·0 × 10 2 −4·0 × 10 6 copies Noborg et al [30] 100-711 copies 263-646 copies Saito et al [47] < 1 × 10 3 copies a In a mixture of patients of different origins, some with liver disease. Anti-HBc, antibody to hepatitis B core antigen; anti-HBs, antibody to hepatitis B surface antigen; geq, genome equivalents.…”

Section: Anti-hbs and Anti-hbc Anti-hbc Only No Markermentioning

confidence: 99%

Occult hepatitis B virus infection: implications in transfusion

Allain¹

2004

Vox Sanguinis

271

247

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Hepatitis B virus (HBV) presents a higher residual risk of transmission by transfusion than hepatitis C virus (HCV) or human immunodeficiency virus (HIV). While most infectious blood units are removed by screening for hepatitis B surface antigen (HBsAg), there is clear evidence that transmission by HBsAg-negative components occurs, in part, during the serologically negative window period, but more so during the late stages of infection. Donations negative for HBsAg, but positive for HBV DNA, with or without the presence of HBV antibodies, correspond to 'occult' HBV infection (OBI). The frequency of OBI depends on the relative sensitivity of both HBsAg and HBV DNA assays. It also depends on the prevalence of HBV infection in the population. OBI may follow recovery from infection, displaying antibody to hepatitis B surface antigen (anti-HBs) and persistent low-level viraemia, escape mutants undetected by the HBsAg assays, or healthy carriage with antibodies to hepatitis B e antigen (anti-HBe) and to hepatitis B core antigen (anti-HBc). Over time, in the latter situation, anti-HBe and, later, anti-HBc may become undetectable. The critical question is whether or not OBI is infectious by transfusion. All forms have been shown to be infectious in immunocompromised individuals, such as organ- or bone marrow-transplant recipients. In immunocompetent recipients, there is no evidence that anti-HBs-containing components (even at low titre) are infectious. Anti-HBc only, with HBV DNA, can be associated with infectivity, as can rare cases of HBV DNA without any serological HBV marker. If HBV nucleic acid amplification technology (NAT) is considered, the OBI viral load would usually be < 500 IU/ml, making testing of plasma pools unsuitable unless the sensitivity of NAT significantly increases by genome enrichment or test improvement.

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“…However, previous or latent HBV infection in the donor liver may be reactivated in the recipient after OLT. The frequency of organ‐donor hepatitis B core antibody (anti‐HBc) positivity is approximately 15% in the United States71 and approximately 10% in Europe 72, 73. Indeed, a high false‐positive rate of anti‐HBc results by enzyme‐linked immunoassay has been reported 74.…”

Section: Use Of Hepatitis B Core Antibody–positive Donors For Transplmentioning

confidence: 99%

Management of the hepatitis B virus in the liver transplantation setting: A European and an American perspective

Terrault¹,

2005

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Prevalence of markers of hepatitis B in the adult German population

Cited by 17 publications

References 0 publications

High levels of serum hepatitis B virus DNA in patients with ‘anti-HBc alone’: role of HBsAg mutants

High levels of serum hepatitis B virus DNA in patients with ‘anti-HBc alone’: role of HBsAg mutants

Occult hepatitis B virus infection: implications in transfusion

Management of the hepatitis B virus in the liver transplantation setting: A European and an American perspective

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