Transmissibility of Hepatitis B Virus (HBV) Infection through Blood Transfusion from Blood Donors with Occult HBV Infection

[Guest guest]

Clin Infect Dis. 2011 Jan 18. [Epub ahead of print]

Transmissibility of Hepatitis B Virus (HBV) Infection through Blood Transfusion

from Blood Donors with Occult HBV Infection.

Yuen MF, Ka-Ho Wong D, Lee CK, Tanaka Y, Allain JP, Fung J, Leung J, Lin CK,

Sugiyama M, Sugauchi F, Mizokami M, Lai CL.

Department of Medicine, The University of Hong Kong, Queen Hospital.

Abstract

Background. Studies of the transmissibility of hepatitis B virus (HBV) in

occult hepatitis B (OHB) through blood transfusion are scarce. We aimed to

determine the transmissibility of HBV in blood donors with OHB through

transfusion in animal and human studies. Methods. Among 217,595 blood donors,

67 donors with OHB were identified. Four chimeric mice populated with human

hepatocytes were inoculated with 2 donor serum samples. Serial serum and liver

HBV DNA levels were measured. Forty-nine recipients of blood transfusions traced

from 10 donors with OHB (9 of whom were positive for antibody to hepatitis B

surface antigen [anti-HBs]) were tested for HBV infection. Homology and

phylogenetic analyses between the HBV genomic sequences of donors and recipients

were performed. Results. Serum HBV DNA was detectable (10(4) copies/mL) in 1

mouse at weeks 5 and 7 after inoculation. Total HBV DNA and HBV replication

template (covalently closed circular DNA) and hepatitis B core antigen were

detected in the mouse liver. After transfusion, 45 recipients (91.8%) had no HBV

infection (ie, they tested negative for hepatitis B surface antigen and HBV

DNA). Four tested positive for HBV DNA. In 3 recipients, 83%-86% homology and

distant phylogenetic relatedness with their donor HBV excluded transmission

through transfusion. The remaining recipient HBV had 95% sequence homology with

her donor HBV, compatible with acquisition of HBV infection from the

transfusion. High anti-HBs levels in 7 other recipients suggested recent

transfusion-related HBV immune response. Conclusions. OHB donor blood

infectivity was shown in our animal and human studies. However, the risk of HBV

transmission in humans was low, especially from blood products obtained from

donors with OHB who were anti-HBs positive.

PMID: 21245155 [PubMed - as supplied by publisher