Annals of Laboratory Medicine

Korean Society for Laboratory Medicine (대한진단검사의학회)
권호 표지
DOI QR코드

DOI QR Code

Pre- and Post-transfusion Testing for Hepatitis B Virus Surface Antigen and Antibody in Blood Recipients: A Single-Institution Experience in an Area of High Endemicity

  • Kim, Hyeong-Su (Department of Preventive Medicine, Konkuk University School of Medicine) ;
  • Hur, Mi-Na (Department of Laboratory Medicine, Konkuk University School of Medicine) ;
  • Moon, Hee-Won (Department of Laboratory Medicine, Konkuk University School of Medicine) ;
  • Park, Chul-Min (Department of Laboratory Medicine, Konkuk University School of Medicine) ;
  • Cho, Jin-Hee (Department of Laboratory Medicine, Konkuk University School of Medicine) ;
  • Park, Kyoung-Sik (Department of Surgery, Konkuk University School of Medicine) ;
  • Lee, Kun-Sei (Department of Preventive Medicine, Konkuk University School of Medicine) ;
  • Chang, Soung-Hoon (Department of Preventive Medicine, Konkuk University School of Medicine)
  • Published : 2012.01.01
⟨ Previous Next ⟩

Abstract

Background: Hepatitis B remains the most common transfusion-transmitted viral infection. We explored the current status of pre-transfusion screening and post-transfusion followup testing for hepatitis B virus (HBV) surface antigen (HBsAg) and antibodies (anti-HBs) in blood recipients from an area of high HBV endemicity. Methods: A total of 7,780 blood recipients were transfused with at least 1 unit of blood component at a single university hospital in Korea between January 2006 and December 2009. Their medical records were reviewed, and their demographic and transfusion-related data were analyzed. Results: Pre-transfusion HBsAg and anti-HBs levels were tested in 77.6% (6,037/7,780) of the recipients. The results varied widely according to recipient age. In all, 32.8% (1,982/6,037) of the recipients who were tested had dual negative pre-transfusion results for HBsAg and anti-HBs and, therefore, were at increased risk of HBV transmission. Post-transfusion follow-up testing for HBsAg and/or anti-HBs was performed in 22% (436/1,982) of the increased-risk group. Conclusions: Our data show that current transfusion-related laboratory testing practice is not sufficient to properly investigate possible post-transfusion infections. Routine laboratory tests, including HBsAg and anti-HBs, should be recommended in transfusion guidelines.

Keywords

References

  1. Candotti D and Allain JP. Transfusion-transmitted hepatitis B virus infection. J Hepatol 2009;51:798-809. https://doi.org/10.1016/j.jhep.2009.05.020
  2. Weber B, Dengler T, Berger A, Doerr HW, Rabenau H. Evaluation of two new automated assays for hepatitis B virus surface antigen (HBsAg) detection: IMMULITE HBsAg and IMMULITE 2000 HBsAg. J Clin Microbiol 2003;41:135-143. https://doi.org/10.1128/JCM.41.1.135-143.2003
  3. Weber B. Genetic variability of the S gene of hepatitis B virus: clinical and diagnostic impact. J Clin Virol 2005;32:102-112. https://doi.org/10.1016/j.jcv.2004.10.008
  4. Yoshikawa A, Gotanda Y, Minegishi K, Taira R, Hino S, Tadokoro K, et al. Lengths of hepatitis B viremia and antigenemia in blood donors: preliminary evidence of occult (hepatitis B surface antigen-negative) infection in the acute stage. Transfusion 2007;47:1162-1171. https://doi.org/10.1111/j.1537-2995.2007.01234.x
  5. Kuhns MC, Kleinman SH, McNamara AL, Rawal B, Glynn S, Busch MP. Lack of correlation between HBsAg and HBV DNA levels in blood donors who test positive for HBsAg and anti-HBc: implications for future HBV screening policy. Transfusion 2004;44:1332-1339. https://doi.org/10.1111/j.1537-2995.2004.04055.x
  6. Vermeulen M, Lelie N, Sykes W, Crookes R, Swanevelder J, Gaggia L, et al. Impact of individual-donation nucleic acid testing on risk of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus transmission by blood transfusion in South Africa. Transfusion 2009;49:1115- 1125. https://doi.org/10.1111/j.1537-2995.2009.02110.x
  7. Song EY, Yun YM, Park MH, Seo DH. Prevalence of occult hepatitis B virus infection in a general adult population in Korea. Intervirology 2009; 52:57-62. https://doi.org/10.1159/000214633
  8. Seo DH, Whang DH, Song EY, Kim HS, Park Q. Prevalence of antibodies to hepatitis B core antigen and occult hepatitis B virus infections in Korean blood donors. Transfusion 2011;51:1840-1846. https://doi.org/10.1111/j.1537-2995.2010.03056.x
  9. Llewelyn CA, Wells AW, Amin M, Casbard A, Johnson AJ, Ballard S, et al. The EASTR study: a new approach to determine the reasons for transfusion in epidemiological studies. Transfus Med 2009;19:89-98. https://doi.org/10.1111/j.1365-3148.2009.00911.x
  10. Wendel S, Levi JE, Biagini S, Candotti D, Allain JP. A probable case of hepatitis B virus transfusion transmission revealed after a 13-monthlong window period. Transfusion 2008;48:1602-1608. https://doi.org/10.1111/j.1537-2995.2008.01723.x
  11. Iudicone P, Miceli M, Palange M, Agresti A, Gallo A, Isacchi G, et al. Hepatitis B virus blood screening: impact of nucleic amplification technology testing implementation on identifying hepatitis B surface antigen non-reactive window period and chronic infections. Vox Sang 2009;96: 292-297. https://doi.org/10.1111/j.1423-0410.2009.01171.x
  12. O'Brien SF, Yi QL, Fan W, Scalia V, Kleinman SH, Vambakas EC. Current incidence and estimated residual risk of transfusion-transmitted infections in donations made to Canadian Blood Services. Transfusion 2007;47:316-325. https://doi.org/10.1111/j.1537-2995.2007.01108.x
  13. Shepard CW, Simard EP, Finelli L, Fiore AE, Bell BP. Hepatitis B virus infection: epidemiology and vaccination. Epidemiol Rev 2006;28:112-125. https://doi.org/10.1093/epirev/mxj009
  14. Liu CJ, Lo SC, Kao JH, Tseng PT, Lai MY, Ni YH, et al. Transmission of occult hepatitis B virus by transfusion to adult and pediatric recipients in Taiwan. J Hepatol 2006;44:39-46. https://doi.org/10.1016/j.jhep.2005.06.016
  15. Roche B, Feray C, Gigou M, Roque-Afonso AM, Arulnaden JL, Delvart V, et al. HBV DNA persistence 10 years after liver transplantation despite successful anti-HBS passive immunoprophylaxis. Hepatology 2003;38: 86-95.
  16. Liang R. How I treat and monitor viral hepatitis B infection in patients receiving intensive immunosuppressive therapies of undergoing hematopoietic stem cell transplantation. Blood 2009;113:3147-3153. https://doi.org/10.1182/blood-2008-10-163493
  17. Inaba S, Ito A, Miyata Y, Ishii H, Kajimoto S, Tanaka M, et al. Individual nucleic amplification technology does not prevent all hepatitis B virus transmission by blood donation. Transfusion 2006;46:2028-2029. https://doi.org/10.1111/j.1537-2995.2006.01011.x

Cited by

  1. Residual risk of transfusion-transmitted infection with human immunodeficiency virus, hepatitis C virus, and hepatitis B virus in Korea from 2000 through 2010 vol.12, pp.None, 2012, https://doi.org/10.1186/1471-2334-12-160
  2. Does the antibody production ability affect the serum anti-Helicobacter pyloriIgG titer? vol.7, pp.3, 2012, https://doi.org/10.4291/wjgp.v7.i3.288