Michael X Fu, Helen M Faddy, Daniel Candotti, Jamel Groves, Paula Saa, Claire Styles, Opeyemi Adesina, Jose Perez Carrillo, Axel Seltsam, Marijke Weber-Schehl, Sheila F O'Brien, Steven J Drews, Nana Benyin Aidoo, Ángel Luis Pajares, Laura Navarro Perez, Xuelian Deng, Thijs van de Laar, Syria Laperche, Riikka Lehtisalo, Soner Yilmaz, Wai-Chiu Tsoi, David Juhl, Christoph Niederhauser, Nahid Chenarsabz, Niamh O'Flaherty, Naoko Goto, Masahiro Satake, Christian Renaud, Antoine Lewin, Marc Cloutier, Salam Sawadogo, Claire Reynolds, Eugene Zhiburt, An Muylaert, Véronique Van Gaever, Michel-Andres Garcia-Otalora, Lisa Jarvis, Marion Vermeulen, Michael Busch, Stuart Blackmore, Ann Jones, Su Brailsford, William L Irving, Monique Andersson, Peter Simmonds, Heli Harvala
{"title":"International review of blood donation screening for anti-HBc and occult hepatitis B virus infection.","authors":"Michael X Fu, Helen M Faddy, Daniel Candotti, Jamel Groves, Paula Saa, Claire Styles, Opeyemi Adesina, Jose Perez Carrillo, Axel Seltsam, Marijke Weber-Schehl, Sheila F O'Brien, Steven J Drews, Nana Benyin Aidoo, Ángel Luis Pajares, Laura Navarro Perez, Xuelian Deng, Thijs van de Laar, Syria Laperche, Riikka Lehtisalo, Soner Yilmaz, Wai-Chiu Tsoi, David Juhl, Christoph Niederhauser, Nahid Chenarsabz, Niamh O'Flaherty, Naoko Goto, Masahiro Satake, Christian Renaud, Antoine Lewin, Marc Cloutier, Salam Sawadogo, Claire Reynolds, Eugene Zhiburt, An Muylaert, Véronique Van Gaever, Michel-Andres Garcia-Otalora, Lisa Jarvis, Marion Vermeulen, Michael Busch, Stuart Blackmore, Ann Jones, Su Brailsford, William L Irving, Monique Andersson, Peter Simmonds, Heli Harvala","doi":"10.1111/trf.18018","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Hepatitis B core antibody (anti-HBc) screening has been implemented in many blood establishments to help prevent transmission of hepatitis B virus (HBV), including from donors with occult HBV infection (OBI). We review HBV screening algorithms across blood establishments globally and their potential effectiveness in reducing transmission risk.</p><p><strong>Materials and methods: </strong>A questionnaire on HBV screening and follow-up strategies was distributed to members of the International Society of Blood Transfusion working party on transfusion-transmitted infectious diseases. Screening data from 2022 were assimilated and analyzed.</p><p><strong>Results: </strong>A total of 30 unique responses were received from 25 countries. Sixteen respondents screened all donations for anti-HBc, with 14 also screening all donations for HBV DNA. Anti-HBc prevalence was 0.42% in all blood donors and 1.19% in new donors in low-endemic countries; however, only 44% of respondents performed additional anti-HBc testing to exclude false reactivity. 0.68% of anti-HBc positive, HBsAg-negative donors had detectable HBV DNA. Ten respondents did universal HBV DNA screening without anti-HBc, whereas four respondents did not screen for either. Deferral strategies for anti-HBc positive donors were highly variable. One transfusion-transmission from an anti-HBc negative donor was reported.</p><p><strong>Discussion: </strong>Anti-HBc screening identifies donors with OBI but also results in the unnecessary deferral of a significant number of donors with resolved HBV infection and donors with false-reactive anti-HBc results. Whilst confirmation of anti-HBc results could be improved to reduce donor deferral, transmission risks associated with anti-HBc negative OBI donors must be considered. In high-endemic areas, highly sensitive HBV DNA testing is required to identify infectious donors.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transfusion","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/trf.18018","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Hepatitis B core antibody (anti-HBc) screening has been implemented in many blood establishments to help prevent transmission of hepatitis B virus (HBV), including from donors with occult HBV infection (OBI). We review HBV screening algorithms across blood establishments globally and their potential effectiveness in reducing transmission risk.
Materials and methods: A questionnaire on HBV screening and follow-up strategies was distributed to members of the International Society of Blood Transfusion working party on transfusion-transmitted infectious diseases. Screening data from 2022 were assimilated and analyzed.
Results: A total of 30 unique responses were received from 25 countries. Sixteen respondents screened all donations for anti-HBc, with 14 also screening all donations for HBV DNA. Anti-HBc prevalence was 0.42% in all blood donors and 1.19% in new donors in low-endemic countries; however, only 44% of respondents performed additional anti-HBc testing to exclude false reactivity. 0.68% of anti-HBc positive, HBsAg-negative donors had detectable HBV DNA. Ten respondents did universal HBV DNA screening without anti-HBc, whereas four respondents did not screen for either. Deferral strategies for anti-HBc positive donors were highly variable. One transfusion-transmission from an anti-HBc negative donor was reported.
Discussion: Anti-HBc screening identifies donors with OBI but also results in the unnecessary deferral of a significant number of donors with resolved HBV infection and donors with false-reactive anti-HBc results. Whilst confirmation of anti-HBc results could be improved to reduce donor deferral, transmission risks associated with anti-HBc negative OBI donors must be considered. In high-endemic areas, highly sensitive HBV DNA testing is required to identify infectious donors.
期刊介绍:
TRANSFUSION is the foremost publication in the world for new information regarding transfusion medicine. Written by and for members of AABB and other health-care workers, TRANSFUSION reports on the latest technical advances, discusses opposing viewpoints regarding controversial issues, and presents key conference proceedings. In addition to blood banking and transfusion medicine topics, TRANSFUSION presents submissions concerning patient blood management, tissue transplantation and hematopoietic, cellular, and gene therapies.