Recent and occult hepatitis B virus infections among blood donors in the United States. Issue 2 (30th November 2018)

• Record Type: Journal Article
• Authors: Ramachandran, Sumathi; Groves, Jamel A.; Xia, Guo‐liang; Saá, Paula; Notari, Edward P.; Drobeniuc, Jan; Poe, Amanda; Khudyakov, Natasha; Schillie, Sarah F.; Murphy, Trudy V.; Kamili, Saleem; Teo, Chong‐Gee; Dodd, Roger Y.; Khudyakov, Yury E.; Stramer, Susan L.
• Is Part Of: Transfusion. Volume 59:Issue 2(2019)
• Page Start: 601
• Page End: 611
• Publication Date: 2018-11-30
• Subjects: Hematology -- Periodicals; Blood -- Transfusion -- Periodicals; Blood Group Antigens -- Periodicals; Blood Preservation -- Periodicals; Blood Transfusion -- Periodicals; 615
• DOI: 10.1111/trf.15057
• Languages: English
• ISSNs: 0041-1132

Abstract

Abstract : BACKGROUND: Characteristics of US blood donors with recent (RBI) or occult (OBI) hepatitis B virus (HBV) infection are not well defined. METHODS: Donors with RBI and OBI were identified by nucleic acid and serologic testing among 34.4 million donations during 2009–2015. Consenting donors were interviewed and their HBV S ‐gene sequenced. RESULTS: The overall rate of HBV‐infected donors was 7.95 per 100, 000; of these, 0.35 per 100, 000 and 1.70 per 100, 000 were RBI and OBI, respectively. RBI (n = 120) and OBI (n = 583) donors constituted 26% of all HBV‐infected (n = 2735) donors. Detection of HBV DNA in 92% of OBI donors required individual donation nucleic acid testing. Donors with OBI compared to RBI were older (mean age, 48 vs 39 years; p < 0.0001) with lower median viral loads (9 vs. 529 IU/mL; p < 0.0001). A higher proportion of OBI than RBI donors were born or resided in an endemic country (39% vs. 5%; p = 0.0078). Seventy‐seven percent of all RBI and OBI donors had multiple sex partners, an HBV‐risk factor. Of 40 RBI and 10 OBI donors whose S gene was sequenced, 33 (83%) and 6 (60%), respectively, carried HBV subgenotype A2; 18 (55%) and 2 (33%), respectively, shared an identical sequence. Infection with 1 or more putative HBV‐immune‐escape mutants was identified in 5 (50%) of OBI but no RBI donors. CONCLUSION: RBI and OBI continue to be identified at low rates, confirming the importance of comprehensive HBV DNA screening of US blood donations. HBV‐infected donors require referral for care and evaluation and contact tracing; their HBV strains may provide important information on emergent genotypes.