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Molecular and serologic tracing of a transfusion‐transmitted hepatitis A virus
Author(s) -
Gowland Peter,
Fontana Stefano,
Niederhauser Christoph,
Taleghani Behrouz Mansouri
Publication year - 2004
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2004.04071.x
Subject(s) - serology , virology , asymptomatic , medicine , antibody , titer , hepatitis a , virus , immunology , immunoglobulin m , biology , hepatitis , immunoglobulin g
BACKGROUND: The transmission of hepatitis A virus (HAV) via blood transfusion has not been evidenced by molecular tracing so far. CASE REPORT: A 33‐year‐old asymptomatic female volunteer made a whole‐blood donation. Thirteen days later an acute HAV infection was diagnosed. Retrospectively, a high viral load was measured by quantitative reverse transcription polymerase chain reaction (RT‐PCR) in the quarantine fresh‐frozen plasma (1.4 × 10 6 geq/mL), whereas immunoglobulin M (IgM) and G (IgG)/IgM anti‐HAV were not detectable and the alanine aminotransferase levels not elevated. The red blood cells have just been transfused on Day 14. The 63‐year‐old male recipient already was HAV seropositive. He did not develop clinical symptoms of HAV and anti‐HAV IgM was not detected. Seventy‐five days later, a 25‐fold increase in the anti‐HAV IgG/IgM titer was observed. Demonstrable HAV ribonucleic acid (RNA) in the recipient by means of RT‐PCR on Day 6, but not on Days 1 and 75, suggests that a transient reinfection did occur. Analyzed sequences of the HAV RNA in the donor and recipient were identical. CONCLUSION: For the first time, transfusion‐transmitted HAV was evidenced by molecular and serologic tracing. The transmitted HAV can survive and replicate for a limited period despite the presence of anti‐HAV IgG.