Anti-HBs positive occult hepatitis B virus carrier blood infectious in two transfusion recipients.
OBJECTIVE
Occult hepatitis B infection (OBI) in blood donations is not considered infectious when anti-HBs is present.


METHODS
Four months after transfusion of eight blood components during coronary arterial bypass surgery, a 59-year-old patient developed acute hepatitis B. A second 71-year-old patient transfused with a red cell concentrate (RCC) from one of these donations had early HBV infection 7 months post-transfusion. Samples were tested for HBV serological markers and HBV DNA was quantified and sequenced.


RESULTS
One implicated donation contained anti-HBc, anti-HBs (12 IU/L) and 180 IU/ml of HBV DNA. Previous and subsequent samples contained 3-10 times lower viral load and slightly variable anti-HBs. Two previous donations did not cause HBV infection. Recipients of the FFP and RCC from the index donation were both HBV infected and carried genotype D strains with sequences identical to the donor strain.


CONCLUSIONS
Despite anti-HBs, an OBI carrier transmitted HBV to two immunocompetent transfusion recipients.
Levicnik-Stezinar
Snezna
S
Blood Transfusion Center of Slovenia, Ljubljana, Slovenia. snezna.levicnik@ztm.si
Rahne-Potokar
Urska
U
Candotti
Daniel
D
Lelie
Nico
N
Allain
Jean-Pierre
JP
D000368:Aged; D000914:Antibodies, Viral / Q000097:blood*; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006509:Hepatitis B / Q000097:blood / Q000175:diagnosis* / Q000635:transmission; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D065227:Transfusion Reaction
D000914:Antibodies, Viral; D004279:DNA, Viral