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Optimal titer of anti‐HBs in blood components derived from donors with anti‐HBc
Author(s) -
Hoshi Yuji,
Hasegawa Takashi,
Yamagishi Naoji,
Mizokami Masashi,
Sugiyama Masaya,
Matsubayashi Keiji,
Uchida Shigeharu,
Nagai Tadashi,
Satake Masahiro
Publication year - 2019
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/trf.15393
Subject(s) - medicine , titer , hepatitis b virus , viremia , blood transfusion , virology , genotype , immunology , hepatitis b , antigen , window period , antibody , human immunodeficiency virus (hiv) , virus , biology , serology , gene , biochemistry
BACKGROUND The ultimate strategy to cope with transfusion‐transmitted hepatitis B virus (HBV) infection caused by transfusion of blood from donors with historical HBV infection is to reject all donors having anti‐HBV core antigen (anti‐HBc). However, this strategy would result in a huge loss of blood donors and subsequent blood inventory collapse. On the other hand, anti‐HBc–positive blood is reportedly not infectious when containing more than 100 mIU/mL of anti‐HBV surface antigen (anti‐HBs). STUDY DESIGN AND METHODS In Japan, anti‐HBc–positive blood has been used for transfusion if it contained 200 mIU/mL or more of anti‐HBs. First, to verify the screening policy, clinical outcomes for transfusion of such blood were analyzed for the 2008–2012 period. Second, human hepatocyte‐repopulated severe combined immunodeficiency mice were inoculated with HBV preincubated with varying doses of anti‐HBs, then viremic status was followed. The effects of anti‐HBs across different HBV genotypes were also investigated. RESULTS Twenty‐three transfusion‐transmitted HBV infections related to anti‐HBc‐positive blood components were identified. None of the blood responsible for these cases contained 200 mIU/mL or more of anti‐HBs. When 100 μL of plasma containing 10 4 copies of HBV and 20 mIU of anti‐HBs was injected into severe combined immunodeficiency mice, no viremia was detected within 13 weeks. Genotype C anti‐HBs was capable of total inhibition of genotype A HBV replication, whereas genotype A anti‐HBs inhibited genotype C HBV to a lesser extent. CONCLUSION Anti‐HBc–positive blood containing 200 mIU/mL or more of anti‐HBs appears safe as a transfusion component. HBV vaccination seems effective between HBV genotypes A and C.