A probable case of hepatitis B virus transfusion transmission revealed after a 13-month-long window period

[Guest guest]

http://www.ingentaconnect.com/content/bsc/trf/2008/00000048/00000008/art00014;js\

essionid=4ln9jhcdtm9h4.alexandra

A probable case of hepatitis B virus transfusion transmission revealed after a

13-month-long window period

Authors: Wendel, Silvano; Levi, José E.; Biagini, Silvana; Candotti, ;

Allain, Jean-Pierre

Source: Transfusion, Volume 48, Number 8, August 2008 , pp. 1602-1608(7)

Publisher: Blackwell Publishing

Abstract:

BACKGROUND:

Transfusion-transmitted hepatitis B virus (HBV) infection in recipients with

drug-related immunodeficiency is rarely described in endemic areas.

Hepatitis B surface antigen (HBsAg)-negative infectious donor blood can be

identified by sensitive nucleic acid testing (NAT). Two immunodeficient patients

who received blood components from a single seronegative blood donor

subsequently found to contain HBV DNA are described. MATERIALS AND METHODS:

Multiple samples from the implicated donor and the two recipients were tested

for HBV serologic and molecular markers. HBV genome fragments were amplified,

sequenced, and phylogenetically analyzed. RESULTS:

The implicated donation had low-level HBV DNA due to the donor being in the

window period before the donor's seroconversion. Recipient 1 had been

vaccinated to HBV and carried anti-HBs but remained negative for all other HBV

markers until she developed acute hepatitis B (viral load 2.7 × 108 IU/mL

and alanine aminotransferase [ALT] level 1744 IU/L) 13 months after

transfusion of red cells. Identical HBV sequences from both donor and recipient

provided evidence of transfusion-related infection. Recipient 2, who received

platelets from the same donation while receiving major chemotherapy, remained

uninfected.

CONCLUSIONS:

In unusual circumstances, HBV incubation time can be considerably prolonged.

Both active and passive neutralizing antibodies to HBV likely delayed, but did

not prevent, acute infection when the immune system was impaired. HBV NAT may

have interdicted the infectious unit, although the donation viral load could not

be quantified and odds of detection calculated.

Document Type: Research article

DOI: 10.1111/j.1537-2995.2008.01723.x

[Guest guest]

http://www.ingentaconnect.com/content/bsc/trf/2008/00000048/00000008/art00014;js\

essionid=4ln9jhcdtm9h4.alexandra

A probable case of hepatitis B virus transfusion transmission revealed after a

13-month-long window period

Authors: Wendel, Silvano; Levi, José E.; Biagini, Silvana; Candotti, ;

Allain, Jean-Pierre

Source: Transfusion, Volume 48, Number 8, August 2008 , pp. 1602-1608(7)

Publisher: Blackwell Publishing

Abstract:

BACKGROUND:

Transfusion-transmitted hepatitis B virus (HBV) infection in recipients with

drug-related immunodeficiency is rarely described in endemic areas.

Hepatitis B surface antigen (HBsAg)-negative infectious donor blood can be

identified by sensitive nucleic acid testing (NAT). Two immunodeficient patients

who received blood components from a single seronegative blood donor

subsequently found to contain HBV DNA are described. MATERIALS AND METHODS:

Multiple samples from the implicated donor and the two recipients were tested

for HBV serologic and molecular markers. HBV genome fragments were amplified,

sequenced, and phylogenetically analyzed. RESULTS:

The implicated donation had low-level HBV DNA due to the donor being in the

window period before the donor's seroconversion. Recipient 1 had been

vaccinated to HBV and carried anti-HBs but remained negative for all other HBV

markers until she developed acute hepatitis B (viral load 2.7 × 108 IU/mL

and alanine aminotransferase [ALT] level 1744 IU/L) 13 months after

transfusion of red cells. Identical HBV sequences from both donor and recipient

provided evidence of transfusion-related infection. Recipient 2, who received

platelets from the same donation while receiving major chemotherapy, remained

uninfected.

CONCLUSIONS:

In unusual circumstances, HBV incubation time can be considerably prolonged.

Both active and passive neutralizing antibodies to HBV likely delayed, but did

not prevent, acute infection when the immune system was impaired. HBV NAT may

have interdicted the infectious unit, although the donation viral load could not

be quantified and odds of detection calculated.

Document Type: Research article

DOI: 10.1111/j.1537-2995.2008.01723.x

[Guest guest]

http://www.ingentaconnect.com/content/bsc/trf/2008/00000048/00000008/art00014;js\

essionid=4ln9jhcdtm9h4.alexandra

A probable case of hepatitis B virus transfusion transmission revealed after a

13-month-long window period

Authors: Wendel, Silvano; Levi, José E.; Biagini, Silvana; Candotti, ;

Allain, Jean-Pierre

Source: Transfusion, Volume 48, Number 8, August 2008 , pp. 1602-1608(7)

Publisher: Blackwell Publishing

Abstract:

BACKGROUND:

Transfusion-transmitted hepatitis B virus (HBV) infection in recipients with

drug-related immunodeficiency is rarely described in endemic areas.

Hepatitis B surface antigen (HBsAg)-negative infectious donor blood can be

identified by sensitive nucleic acid testing (NAT). Two immunodeficient patients

who received blood components from a single seronegative blood donor

subsequently found to contain HBV DNA are described. MATERIALS AND METHODS:

Multiple samples from the implicated donor and the two recipients were tested

for HBV serologic and molecular markers. HBV genome fragments were amplified,

sequenced, and phylogenetically analyzed. RESULTS:

The implicated donation had low-level HBV DNA due to the donor being in the

window period before the donor's seroconversion. Recipient 1 had been

vaccinated to HBV and carried anti-HBs but remained negative for all other HBV

markers until she developed acute hepatitis B (viral load 2.7 × 108 IU/mL

and alanine aminotransferase [ALT] level 1744 IU/L) 13 months after

transfusion of red cells. Identical HBV sequences from both donor and recipient

provided evidence of transfusion-related infection. Recipient 2, who received

platelets from the same donation while receiving major chemotherapy, remained

uninfected.

CONCLUSIONS:

In unusual circumstances, HBV incubation time can be considerably prolonged.

Both active and passive neutralizing antibodies to HBV likely delayed, but did

not prevent, acute infection when the immune system was impaired. HBV NAT may

have interdicted the infectious unit, although the donation viral load could not

be quantified and odds of detection calculated.

Document Type: Research article

DOI: 10.1111/j.1537-2995.2008.01723.x

[Guest guest]

http://www.ingentaconnect.com/content/bsc/trf/2008/00000048/00000008/art00014;js\

essionid=4ln9jhcdtm9h4.alexandra

A probable case of hepatitis B virus transfusion transmission revealed after a

13-month-long window period

Authors: Wendel, Silvano; Levi, José E.; Biagini, Silvana; Candotti, ;

Allain, Jean-Pierre

Source: Transfusion, Volume 48, Number 8, August 2008 , pp. 1602-1608(7)

Publisher: Blackwell Publishing

Abstract:

BACKGROUND:

Transfusion-transmitted hepatitis B virus (HBV) infection in recipients with

drug-related immunodeficiency is rarely described in endemic areas.

Hepatitis B surface antigen (HBsAg)-negative infectious donor blood can be

identified by sensitive nucleic acid testing (NAT). Two immunodeficient patients

who received blood components from a single seronegative blood donor

subsequently found to contain HBV DNA are described. MATERIALS AND METHODS:

Multiple samples from the implicated donor and the two recipients were tested

for HBV serologic and molecular markers. HBV genome fragments were amplified,

sequenced, and phylogenetically analyzed. RESULTS:

The implicated donation had low-level HBV DNA due to the donor being in the

window period before the donor's seroconversion. Recipient 1 had been

vaccinated to HBV and carried anti-HBs but remained negative for all other HBV

markers until she developed acute hepatitis B (viral load 2.7 × 108 IU/mL

and alanine aminotransferase [ALT] level 1744 IU/L) 13 months after

transfusion of red cells. Identical HBV sequences from both donor and recipient

provided evidence of transfusion-related infection. Recipient 2, who received

platelets from the same donation while receiving major chemotherapy, remained

uninfected.

CONCLUSIONS:

In unusual circumstances, HBV incubation time can be considerably prolonged.

Both active and passive neutralizing antibodies to HBV likely delayed, but did

not prevent, acute infection when the immune system was impaired. HBV NAT may

have interdicted the infectious unit, although the donation viral load could not

be quantified and odds of detection calculated.

Document Type: Research article

DOI: 10.1111/j.1537-2995.2008.01723.x