title: Anti-HBs positive occult hepatitis B virus carrier blood infectious in two transfusion recipients.
abstract: 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.
authors.affiliation: Blood Transfusion Center of Slovenia, Ljubljana, Slovenia. snezna.levicnik@ztm.si
authors.forename: Snezna
authors.initials: S
authors.lastname: Levicnik-Stezinar
authors.forename: Urska
authors.initials: U
authors.lastname: Rahne-Potokar
authors.forename: Daniel
authors.initials: D
authors.lastname: Candotti
authors.forename: Nico
authors.initials: N
authors.lastname: Lelie
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Allain
mesh_terms: 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
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral