Use of an HBV-DNA hybridization assay in the evaluation of equivocal hepatitis B virus tests in solid organ donors.
BACKGROUND
Serological markers for the hepatitis B virus are routinely used in the evaluation of potential organ donors. However, serological tests can be associated with significant false or equivocal results and may not be indicative of the true risk of hepatitis B infection. Studies have recently questioned the significance of an isolated hepatitis B core antibody test in evaluating the suitability of solid organs for transplantation. The ability to detect hepatitis B virus DNA may prove useful when the diagnosis of hepatitis B infection is in doubt.


METHODS
Serum samples from 16 donors with equivocal or positive hepatitis B core antibody and/or hepatitis B surface antigen serological screening tests were retrospectively tested for the presence of hepatitis B DNA. Any available follow-up data on the placement of organs from these donors was obtained.


RESULTS
One of the 16 (6.3%) donors tested positive for the presence of hepatitis B DNA, but organs from this donor were not recovered or transplanted. Follow-up on 14 organs recovered and transplanted from 6 donors in this group did not show clinical and/or laboratory evidence of hepatitis B infection in the recipients.


CONCLUSIONS
In our donor population, there was a low incidence (6.3%) of donors with equivocal or positive hepatitis B core antibody and/or hepatitis B surface antigen serological screening tests who subsequently demonstrated the presence of detectable hepatitis B DNA. Posttransplantation follow-up of the recipients of 14 recovered organs failed to demonstrate any cases of posttransplant hepatitis B infection.
Domen
R E
RE
Department of Clinical Pathology, Cleveland Clinic Foundation, Ohio, USA.
Yen-Lieberman
B
B
Nelson
K A
KA
Chua
J
J
Sholtis
W
W
Tyus
H
H
Isada
C M
CM
D004279:DNA, Viral / Q000032:analysis* / Q000235:genetics*; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000097:blood* / Q000175:diagnosis* / Q000276:immunology; D006512:Hepatitis B Core Antigens / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics*; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D009693:Nucleic Acid Hybridization / Q000379:methods*; D015203:Reproducibility of Results; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000379:methods*
D004279:DNA, Viral; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens