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Molecular characterization of occult hepatitis B cases in Greek blood donors
Author(s) -
Katsoulidou Antigoni,
Paraskevis Dimitrios,
Magiorkinis Emmanouil,
Moschidis Zissis,
Haida Catherine,
Hatzitheodorou Eleni,
Varaklioti Agoritsa,
Karafoulidou Anastasia,
Hatzitaki Maria,
Kavallierou Lilian,
Mouzaki Athanasia,
Andrioti Evaggelia,
Veneti Chrysanthi,
Kaperoni Athanasia,
Zervou Eleftheria,
Politis Constantina,
Hatzakis Angelos
Publication year - 2009
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.21499
Subject(s) - hbsag , virology , hepatitis b virus , medicine , serology , occult , hepatitis b , orthohepadnavirus , polymerase chain reaction , multiplex , hepadnaviridae , immunology , virus , antibody , biology , gene , pathology , genetics , alternative medicine
The use of sensitive nucleic acid testing for hepatitis B virus in blood donors revealed a number of HBV DNA(+) cases among HBsAg(−) donors, a status known as occult HBV infection. The purpose of this study was the serological and molecular characterization of occult HBV infection in Greek blood donors. A prospective study was undertaken in order to identify occult HBV infection cases in blood donors. As part of the routine screening of blood donations in Greece, blood units were screened individually by a multiplex HIV‐1/HCV/HBV nucleic acid assay. Initially reactive samples were retested with discriminatory assays. HBV DNA(+)/HBsAg(−) samples were tested further for HBV serological markers and HBV DNA was quantified by real‐time PCR. Molecular characterization was performed by sequencing the envelope and polymerase genes of HBV. Preliminary screening revealed 21 occult cases with the following patterns: anti‐HBc only: 7 donors, anti‐HBc/anti‐HBs: 7 donors, anti‐HBc/anti‐HBe: 5 donors, anti‐HBc/anti‐HBs/anti‐HBe: 2 donors. In all cases, the HBV DNA load was <351 IU/ml. Sequencing was successful in 10 donors (classified within genotype D) revealing several amino acid substitutions related to diagnostic escape and antiviral resistance. HBsAg diagnostic failure and low viral replication in occult HBV infection carriers could possibly be attributed to multiple changes in envelope and polymerase regions, respectively. J. Med. Virol. 81:815–825, 2009. © 2009 Wiley‐Liss, Inc.