Prevention of Transmission of Hepatitis B, Hepatitis C and Human Immunodeficiency Virus Infections Through Blood Transfusion by Anti‐HBc Testing

Transmission of occult hepatitis B virus by transfusion to adult and pediatric recipients in Taiwan

“…Notably, if each recipient received in average 10 units of blood component, then the risk of transfusiontransmitted HBV infection would be 0.01% per unit (100 per million units). By contrast, the risk of transfusiontransmitted HBV infection was around 2.5 to 19.2 per million units in western countries and Japan [3][4][5][6][7][8]41]. Therefore, the risk of transfusion-transmitted HBV infection in Taiwan was at least 7w40-fold higher.…”

“…Currently, serologic screening is the main method used to reduce the frequency of transfusion-transmitted viral infections. In western countries where the prevalence of HBV infection is low, it effectively decreases infection rates to approximately 2.5 per million [3][4][5][6][7][8]. However in hepatitis B endemic areas, using new viral detection technology especially the nucleic acid amplification test (NAT), it has been discovered that among individuals with past hepatitis B infection and seronegative for hepatitis B s antigen (HBsAg), around 3-30% actually retained viral DNA in their blood or blood cells.…”

“…It is imperative to know how often HBV DNA-positive blood from donors with occult HBV infection is transfused into recipients and what the consequences are [14,15] From another aspect, the screening program for HBV infection among blood donors differs between developed and developing countries where prevalence of HBV infection differs greatly. In low prevalence countries, like the United States and Japan, blood donors are screened for both HBsAg and antibody to hepatitis B core antigen (anti-HBc) [5,16]. Individuals positive for either are disqualified because of ongoing or past infections.…”

Health Care–Associated Transmission of Hepatitis B and C in Oncology Care

“…17 The risks of acquiring infection with HBV during oncology therapy are related to the sensitivity of the testing used for blood product screening and the prevalence of disease in the population. 10,12 There is a great disparity between regions in the prevalence of HBV infection. For example, more than 80% of people in West Africa have evidence of exposure to HBV and less than 0.5%, in the United Kingdom.…”

“…However, adding this test to blood donor screening also helped to identify donors who were in the ''window phase'' of HBV infection (wherein HBsAg has disappeared but antibody to HBsAg is not yet present). 11,12 More recently, nucleic acid testing (NAT) for HBV has been developed. 6,13 One Polish study of children treated for cancer from 1974 to 2000 noted that 74 of 119 patients (62.2%) had evidence of exposure to HBV before 1992.…”