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Occult hepatitis B virus infection among blood donors from the B razilian A mazon: implications for transfusion policy
Author(s) -
Moresco M. N. dos S.,
Virgolino H. de A.,
Morais M. P. E.,
MottaPassos I.,
GomesGouvêa M. S.,
Assis L. M. S.,
Aguiar K. R. de L.,
Lombardi S. C. F.,
Malheiro A.,
Cavalheiro N. de P.,
Levi J. E.,
Torres K. L.
Publication year - 2014
Publication title -
vox sanguinis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.68
H-Index - 83
eISSN - 1423-0410
pISSN - 0042-9007
DOI - 10.1111/vox.12125
Subject(s) - hbsag , hepatitis b virus , virology , medicine , immunology , antibody , hepatitis b , viremia , population , antigen , orthohepadnavirus , infectivity , asymptomatic , virus , hepadnaviridae , environmental health
Background Brazil requires the performance of both a test for hepatitis B surface antigen ( HB s A g) 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‐ HB c reactivity. We evaluated the potential infectivity of donations positive for anti‐ HB c in search of a rational approach for the handling of these collections. Study Design and Methods We tested anti‐ HB c reactive blood donations from the state of A mazonas for the presence of HBV DNA and for titres of anti‐ HB s. The study population consists of village‐based donors from the interior of A mazonas state. Results Among 3600 donations, 799 were anti‐ HB c 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 HB s A g and positive for HBV DNA and were defined as occult B virus infections (2·7%). Six of those eight specimens had anti‐ HB s titres above 100 mIU/ml, indicating the concomitant presence of the virus with high antibody titres. Conclusion A small proportion of anti‐ HB c reactive donors carry HBV DNA and anti‐ HB s 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‐ HB c reactive units in critical situations.