Molecular and serologic tracing of a transfusion-transmitted hepatitis A virus.
BACKGROUND
The transmission of hepatitis A virus (HAV) via blood transfusion has not been evidenced by molecular tracing so far.


METHODS
A 33-year-old asymptomatic female volunteer made a whole-blood donation. Thirteen days later an acute HAV infection was diagnosed. Retrospectively, a high viral load was measured by quantitative reverse transcription polymerase chain reaction (RT-PCR) in the quarantine fresh-frozen plasma (1.4 x 10(6) geq/mL), whereas immunoglobulin M (IgM) and G (IgG)/IgM anti-HAV were not detectable and the alanine aminotransferase levels not elevated. The red blood cells have just been transfused on Day 14. The 63-year-old male recipient already was HAV seropositive. He did not develop clinical symptoms of HAV and anti-HAV IgM was not detected. Seventy-five days later, a 25-fold increase in the anti-HAV IgG/IgM titer was observed. Demonstrable HAV ribonucleic acid (RNA) in the recipient by means of RT-PCR on Day 6, but not on Days 1 and 75, suggests that a transient reinfection did occur. Analyzed sequences of the HAV RNA in the donor and recipient were identical.


CONCLUSIONS
For the first time, transfusion-transmitted HAV was evidenced by molecular and serologic tracing. The transmitted HAV can survive and replicate for a limited period despite the presence of anti-HAV IgG.
Gowland
Peter
P
Blood Transfusion Service Berne, Swiss Red Cross, Switzerland. peter.gowland@bsd-be.ch
Fontana
Stefano
S
Niederhauser
Christoph
C
Taleghani
Behrouz Mansouri
BM
D000328:Adult; D001483:Base Sequence; D005260:Female; D006506:Hepatitis A / Q000635:transmission*; D035922:Hepatitis A Antibodies / Q000097:blood; D030041:Hepatitis A virus / Q000235:genetics* / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D012367:RNA, Viral / Q000097:blood; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013997:Time Factors; D065227:Transfusion Reaction; D019562:Viral Load
D035922:Hepatitis A Antibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D012367:RNA, Viral