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Occult hepatitis B virus infection.

Jean-Pierre Allain1

  • 1Division of Transfusion Medicine, Department of Haematology, University of Cambridge, Cambridge Blood Centre, Long Road, Cambridge CR2 2PT, UK. jpa1000@cam.ac.uk

Transfusion Clinique Et Biologique : Journal De La Societe Francaise De Transfusion Sanguine
|February 26, 2004
PubMed
Summary

Occult Hepatitis B infection (OBI) involves detecting HBV DNA without HBsAg, posing transfusion risks. Screening methods like anti-HBc and sensitive HBV DNA tests are crucial for blood safety.

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Area of Science:

  • Hepatology
  • Virology
  • Transfusion Medicine

Background:

  • Occult Hepatitis B infection (OBI) is defined by the presence of HBV DNA without detectable HBsAg, often with HBV antibodies.
  • OBI is found in various conditions including hepatocellular carcinoma, chronic hepatitis B, and resolved infections.
  • The detection frequency of OBI relies on assay sensitivity and HBV prevalence.

Purpose of the Study:

  • To explore the origins and implications of occult Hepatitis B virus (HBV) infection in blood donors.
  • To assess the transmissibility of occult HBV through blood transfusion.
  • To evaluate the effectiveness of current screening methods for occult HBV.

Main Methods:

  • Review of existing literature on occult HBV infection.
  • Analysis of HBV DNA and serological marker detection methods (HBsAg, anti-HBs, anti-HBc).

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  • Evaluation of transfusion transmission risks in different recipient populations.
  • Main Results:

    • Occult HBV can originate from recovered infections, low-level replication, or chronic carriage, often with anti-HBc only.
    • Viral loads in OBI are typically low (<10(4) IU/ml), challenging pooled nucleic acid testing (NAT).
    • Donations with anti-HBc and HBV DNA can be infectious, particularly for immunosuppressed recipients.

    Conclusions:

    • Anti-HBc screening detects most OBI but is not exhaustive.
    • Highly sensitive individual donation NAT is necessary to eliminate infectious units.
    • Understanding OBI is critical for ensuring blood transfusion safety.