Occult Hepatitis B Virus Infection Among Blood Donors from the Brazilian Amazon: Implications for Transfusion Policy

Overview

Journal Vox Sang

Specialty Hematology

Date 2014 Apr 5

PMID 24697276

Citations 6

Authors

M N dos S Moresco

H de A Virgolino

M P E de Morais

I da Motta-Passos

M S Gomes-Gouvea

L M S de Assis

K R de L Aguiar

S C F Lombardi

A Malheiro

N de P Cavalheiro

J E Levi

K L Torres

Affiliations

Soon will be listed here.

Abstract

Background: Brazil requires the performance of both a test for hepatitis B surface antigen (HBsAg) and a test for antibodies to the core of hepatitis B for blood donor screening. Blood centres in regions of high HBV endemicity struggle to maintain adequate stocks in face of the high discard rates due to anti-HBc reactivity. We evaluated the potential infectivity of donations positive for anti-HBc in search of a rational approach for the handling of these collections.

Study Design And Methods: We tested anti-HBc reactive blood donations from the state of Amazonas for the presence of HBV DNA and for titres of anti-HBs. The study population consists of village-based donors from the interior of Amazonas state.

Results: Among 3600 donations, 799 were anti-HBc reactive (22·2%). We were able to perform real-time PCR for the HBV S gene on specimens from 291 of these donors. Eight of these samples were negative for HBsAg and positive for HBV DNA and were defined as occult B virus infections (2·7%). Six of those eight specimens had anti-HBs titres above 100 mIU/ml, indicating the concomitant presence of the virus with high antibody titres.

Conclusion: A small proportion of anti-HBc reactive donors carry HBV DNA and anti-HBs testing is not useful for predicting viremia on them. This finding indicates the possibility of HBV transmission from asymptomatic donors, especially in areas of high HBV prevalence. Sensitive HBV DNA nucleic acid testing may provide another level of safety, allowing eventual use of anti-HBc reactive units in critical situations.

Citing Articles

Safety of Hepatitis B Virus Screening in Blood Donors from the Hospital Foundation of Hematology and Hemotherapy of the State of Amazonas (HEMOAM) in the Brazilian Amazon.

Belota R, Silva J, Nascimento E, Abrahim C, Castilho M, Moura Neto J Viruses. 2024; 16(10).

PMID: 39459965 PMC: 11512298. DOI: 10.3390/v16101632.

Prevalence and trends in transfusion-transmissible infections among blood donors in Brazil from 2010 to 2016.

Pessoni L, Aquino E, Alcantara K Hematol Transfus Cell Ther. 2019; 41(4):310-315.

PMID: 31409582 PMC: 6978541. DOI: 10.1016/j.htct.2019.03.009.

Detection and molecular characterisation of a diagnosis escape variant associated with occult hepatitis B virus in Brazil.

Almeida R, Mello F, Menegoy I, Espirito Santo M, Ginuino C, De Sousa P Mem Inst Oswaldo Cruz. 2017; 112(7):485-491.

PMID: 28591309 PMC: 5452485. DOI: 10.1590/0074-02760160477.

Screening and diagnosis of HBV in low-income and middle-income countries.

Allain J, Opare-Sem O Nat Rev Gastroenterol Hepatol. 2016; 13(11):643-653.

PMID: 27625189 DOI: 10.1038/nrgastro.2016.138.

Characterisation and follow-up study of occult hepatitis B virus infection in anti-HBc-positive qualified blood donors in southern China.

Ye X, Li T, Xu X, Du P, Zeng J, Zhu W Blood Transfus. 2016; 15(1):6-12.

PMID: 27416568 PMC: 5269423. DOI: 10.2450/2016.0268-15.

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