Occult and active hepatitis B virus detection in donated blood in Sao Paulo, Brazil

Author(s):Show less -

Nishiya, Anna S. ^{[1, 2]} ; Levi, Jose E. ^[3] ; de Almeida-Neto, Cesar ^{[1, 4]} ; Witkin, Steven S. ^{[5, 3]} ; Ferreira, Suzete C. ^{[1, 2]} ; Bassit, Leda ^{[6, 7]} ; Sabino, Ester C. ^{[3, 4]} ; Di-Lorenzo-Oliveira, Claudia ^[8] ; Salles, Nanci A. ^[1] ; Coutinho, Adenilson S. ^[1] ; Bellesa, Maria A. ^[1] ; Rocha, Vanderson ^{[9, 1, 2, 4]} ; Mendrone-Jr, Alfredo

Affiliation

^[1] Fundacao Prosangue, Hemoctr Sao Paulo, Ave Dr Eneas de Carvalho Aguiar, 155, 1 Floor, BR-05403000 Sao Paulo, SP - Brazil

^[2] Univ Sao Paulo, Lab Med Invest Pathogenesis & Targeted Therapy On, Dept Hematol, Hosp Clin HCFMUSP, Fac Med, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Inst Med Trop, Sao Paulo - Brazil

^[4] Univ Sao Paulo FMUSP, Fac Med, Disciplina Ciencias Med, Sao Paulo - Brazil

^[5] Weill Cornell Med, Dept Obstet & Gynecol, New York, NY - USA

^[6] Emory Univ, Dept Pediat, Biochem Pharmacol Lab, Ctr AIDS Res, Atlanta, GA - USA

^[7] Childrens Healthcare Atlanta, Atlanta, GA - USA

^[8] Univ Sao Joao dei Rei, Divinopolis - Brazil

^[9] Univ Oxford, Churchill Hosp, Oxford - England

• Document type: Journal article
• Source: Transfusion; v. 61, n. 5 MAR 2021.
• Web of Science Citations: 0

Abstract

Background The present study determined the HBV antigen, antibody, and DNA status in blood donations deemed to be HBV positive. Individuals with an occult HBV infection (OBI), defined as being positive for HBV DNA but negative for HBV surface antigen (HBsAg), as well as those with active infection (HBsAg-positive), were identified and characterized. Study Design and Methods From a total pool if 198,363 blood donations, we evaluated in a cross-sectional study, 1106 samples that were positive in screening tests for antibody to HBV core antigen (HBcAb), HBsAg, and/or HBV DNA by nucleic acid testing (NAT-HBV). The presence of genetic variants in the HBV pol/S gene in individuals with an active HBV infection was also determined. Results OBIs were detected in six of 976 samples (0.6%) that were positive only for HBcAb. The rate of HBV active infection was 0.024% (48/198,363) and there was a predominance of HBV sub-genotype A1 (62.2%, 28/45), followed by D3 (17.8%, 8/45). Mutations in the S gene were found in 57.8% (26/45) and immune escape mutations in 37.8% (17/45) of active HBV-infected donors. Among them, T123N, G145A, and D144G high-impact immune escape mutations were identified. Conclusion Highly sensitive molecular tests improve the capacity to detect OBIs. When NAT is performed in pooled samples, HBcAb test has value in the detection of donors with OBI and improves transfusion safety. Mutations in the S gene are frequent in HBsAg-positive blood, including those associated with diagnostic failure and vaccine escape mutations. (AU)

• FAPESP's process: 17/16658-6 - BIOLOGICAL MEANING OF HEPATITIS B VIRUS MARKERS (HBV) IN BLOOD DONORS: ISOLATED Anti-HBc AND ISOLATED HBsAg.
• Grantee: Anna Shoko Nishiya Oshiro
• Support Opportunities: Regular Research Grants