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Anti-HBs positive occult hepatitis B virus carrier blood infectious in two transfusion recipients
Snezna Levicnik-Stezinar1, Urska Rahne-Potokar, Daniel Candotti
1Blood Transfusion Center of Slovenia, Ljubljana, Slovenia. snezna.levicnik@ztm.si
Background/Aims:
Occult hepatitis B infection (OBI) in blood donations is not considered infectious when anti-HBs is present.
Methods:
Four months after transfusion of eight blood components during coronary arterial bypass surgery, a 59-year-old patient developed acute hepatitis B. A second 71-year-old patient transfused with a red cell concentrate (RCC) from one of these donations had early HBV infection 7 months post-transfusion. Samples were tested for HBV serological markers and HBV DNA was quantified and sequenced.
Results:
One implicated donation contained anti-HBc, anti-HBs (12 IU/L) and 180 IU/ml of HBV DNA. Previous and subsequent samples contained 3-10 times lower viral load and slightly variable anti-HBs. Two previous donations did not cause HBV infection. Recipients of the FFP and RCC from the index donation were both HBV infected and carried genotype D strains with sequences identical to the donor strain.
Conclusions:
Despite anti-HBs, an OBI carrier transmitted HBV to two immunocompetent transfusion recipients.
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