Blood donor infected VHB detected by NAT probable phase in clinical resolution
DOI:
https://doi.org/10.5281/zenodo.10790554Keywords:
Hepatitis B Surface Antigens, Nucleic Acid Amplification Techniques, Hepatitis B Virus, Blood DonorsAbstract
Background: In Mexico, the detection of hepatitis B virus (HBV) in blood donors is achieved by screening for hepatitis B surface antigen (HBsAg). However there is still a residual risk of HBV transmission by blood components of donor suffering from occult HBV infection (OBI) or during the window period before seroconversion; in both the antigen expression can be undetectable.
Clinical case: A 55 year old female donated whole blood in our blood bank,at health history and physical examination no health risk factors were detected. The whole blood was screened, the NAT assay was reactive therefore is screened by discriminatory assay for specific probes, resulting reactive for HBV. A second sample is tested for Hepatitis B serological markers, the sample was reactive for NAT HBV assay, anti-HB core IgG positive, non reactive HBsAg; these results reject a window period.
Five months later a third sample was taken, NAT HBV and HBsAg test results were not reactive. We conclude this was a probable OBI infection or probable phase in clinical resolution for Hepatitis B case.
Conclusion: This type of cases demonstrates the need and advantage the availability of sensitive and specific methods for the detection of viral genome or serological markers that increase blood safety for the recipients of whole blood, hematopoietic stem cells and tissues.
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References
Norma oficial mexicana NOM-253-SSA1-2012, Para la disposición de sangre humana y sus componentes con fines terapéuticos [Internet]. Diario Oficial de la Federación: México. 2012 [actualización 2012 10 26]. Disponible en: http://www.cnts.salud.gob.mx/descargas/NOM-253-SSA1-2012.pdf.
Datta S, Banerjee A, Chandra PK, et al. Detection of premature stop codon in the suface gene of hepatitis B virus from an HBsAg and antiHBc negative blood donor. J Clin Virol. 2007;40(3):255-8. doi: 10.1016/j.jcv.2007.08.003.
Knipe DM, Howley P, Giffin D, et al. Fields Virology. 5a ed. Estados Unidos: Wolters Kluwer; 2007. 3091 p.
Tabor E, Gerety RJ. Transmission of hepatitis B by immune serum globulin. Lancet. 1979;2(8155):1293. doi: 10.1016/s0140-6736(79)92296-7.
Michalak TI, Pardoe IU, Coffin CS, et al. Occult lifelong persistence of infectious hepadnavirus and residual liver inflammation in woodchucks convalescent from acute viral hepatitis. Hepatology. 1999;29(3):928–38. doi: 10.1002/hep.510290329.
Mak LY, Wong DK, Pollicino T, et al. Occult hepatitis B infection and hepatocellular carcinoma: Epidemiology, virology, hepatocarcinogenesis and clinical significance. J Hepatol. 2020;73(4):952-64. doi: 10.1016/j.jhep.2020.05.042.
Hourfar MK, Jork C, Schottstedt V, et al. Experience of German Red Cross blood donor services with nucleic acid testing: results of screening more than 30 million blood donations for human immunodeficiency virus-1, hepatitis C virus, and hepatitis B virus. Transfusion. 2008;48(8):1558-66. doi: 10.1111/j.1537-2995.2008.01718.x.
World Health Organization. Global hepatitis report, 2017 [Internet]. World Healt Organization; 2017 [citado 2023 10 24]. Disponible en: https://www.who.int/publications/i/item/9789241565455.
Thomas DL. Global elimination of chronic hepatitis. N Engl J Med. 2019;380(21):2041-50. doi: 10.1056/NEJMra1810477.
Péneau C, Imbeaud S, La Bella T, et al. Hepatitis B virus integrations promote local and distant oncogenic driver alterations in hepatocellular carcinoma. Gut. 2022;71(3):616-26. doi: 10.1136/gutjnl-2020-323153.
Li CL, Li CY, Lin YY, et al. Androgen Receptor Enhances Hepatic Telomerase Reverse Transcriptase Gene Transcription After Hepatitis B Virus Integration or Point Mutation in Promoter Region. Hepatology. 2019;69(2):498-512. doi: 10.1002/hep.30201.
Bayard Q, Meunier L, Peneau C, et al. Cyclin A2/E1 activation defines a hepatocellular carcinoma subclass with a rearrangement signature of replication stress. Nat Commun. 2018;9(1):5235. doi: 10.1038/s41467-018-07552-9.
Dong H, Zhang L, Qian Z, et al. Identification of HBV-MLL4 Integration and Its Molecular Basis in Chinese Hepatocellular Carcinoma. PLoS One. 2015;10(4):e0123175. doi: 10.1371/journal.pone.0123175.
Furuta M, Tanaka H, Shiraishi Y, et al. Characterization of HBV integration patterns and timing in liver cancer and HBV-infected livers. Oncotarget. 2018;9(38):25075-88. doi: 10.18632/oncotarget.25308.
Ali SM, Raza N, Irfan M, et al. Effectiveness of Using Nucleic Acid Amplification Test to Screen Blood Donors for Hepatitis B, Hepatitis C, and HIV: A Tertiary Care Hospital Experience From Pakistan. Cureus. 2023;15(1):e34216. doi: 10.7759/cureus.34216.
Benitez-Arvizu, Franco-Goméz NE, Flores-Sanchez I, et al. Estudio de un período de ventana documentado por técnica de ácidos nucleicos. Rev Mex Med Tran. 2017; 10(1):18-21. Disponible en: https://www.medigraphic.com/pdfs/transfusional/mt-2017/mt171c.pdf.
Cortés AA, Sanchez DG, Rivera LMR, et al. Período de ventana de virus de hepatitis B, detección por biología molecular (NAT). Rev Mex Med Tran. 2020;13(1); 15-21. Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=95495.
Raimondo G, Locarnini S, Pollicino T, et al. Update of the statements on biology and clinical impact of occult hepatitis B virus infection. J Hepatol. 2019;71(2):397-408. doi: 10.1016/j.jhep.2019.03.034.
Altunay H, Kosan E, Birinci I, et al. Are isolated anti-HBc blood donors in high risk group? The detection of HBV DNA in isolated anti-HBc cases with nucleic acid amplification test (NAT) based on transcription-mediated amplification (TMA) and HBV discrimination. Transfus Apher Sci. 2010;43(3):265-8. doi: 10.1016/j.transci.2010.09.012.
Cai J, Wu W, Wu J, et al. Prevalence and clinical characteristics of hepatitis B surface antigen-negative/hepatitis B core antibody-positive patients with detectable serum hepatitis B virus DNA. Ann Transl Med. 2022;10(1):25. doi: 10.21037/atm-21-6272.
Wang C, Xue R, Wang X, et al. High-sensitivity HBV DNA test for the diagnosis of occult HBV infection: commonly used but not reliable. Front Cell Infect Microbiol. 2023;13:1186877. doi: 10.3389/fcimb.2023.1186877.
Aguilera-Guirao A, Fernandez RA, Cordoba-Cortijo J, et al. Diagnóstico microbiológico de las hepatitis víricas. En: Procedimientos en Microbiología Clínica. Recomendaciones de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Madrid: Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica; 2014. 48 p. Disponible en: https://seimc.org/contenidos/documentoscientificos/procedimientosmicrobiologia/seimc-procedimientomicrobiologia50.pdf.
Guerrero-García JJ, Zúñiga-Magaña AG, Barrera-De León JC, et al. Retrospective Study of the Seroprevalence of HIV, HCV, and HBV in Blood Donors at a Blood Bank of Western Mexico. Pathogens. 2021;10(7):878. doi: 10.3390/pathogens10070878.
Wachs ME, Amend WJ, Ascher NL, et al. The risk of transmission of hepatitis B from HBsAg(-), HBcAb(+), HBIgM(-) organ donors. Transplantation. 1995 Jan 27;59(2):230-4.
Satterthwaite R, Ozgu I, Shidban H, et al. Risks of transplanting kidneys from hepatitis B surface antigen-negative, hepatitis B core antibody-positive donors. Transplantation 1997;64(3):432-5. doi: 10.1097/00007890-199708150-00011.
Departament of Healt and Human Services. Use of Nucleic Acid Tests to Reduce the Risk of Transmission of Hepatitis B Virus from Donors of Human Cells, Tissues, and Cellular and Tissue-Based Products. Guidance for Industry [Internet]. Estados Unidos: Center for Biologics Evaluation and Research; 2016 [citado 2023 10 24]. 8p. Disponible en: https://www.fda.gov/media/99642/download.
Zou S, Stramer SL, Notari EP, et al. Current incidence and residual risk of hepatitis B infection among blood donors in the United States. Transfusion. 2009;49(8):1609-20. doi: 10.1111/j.1537-2995.2009.02195.x.
Dodd RY, Crowder LA, Haynes JM, et al. Screening blood donors for HIV, HCV, and HBV at the American Red Cross: 10-year trends in prevalence, incidence, and residual risk, 2007 to 2016. Transfus Med Rev. 2020;34(2):81–93. doi: 10.1016/j.tmrv.2020.02.001.
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