title: Anti-hepatitis B core antigen testing with detection and characterization of occult hepatitis B virus by an in-house nucleic acid testing among blood donors in Behrampur, Ganjam, Orissa in southeastern India: implications for transfusion.
abstract: BACKGROUND
  Occult hepatitis B virus (HBV) infection might transmit viremic units into the public blood supply if only hepatitis B surface antigen (HBsAg) testing is used for donor screening. Our aim was to evaluate the prevalence of occult HBV infection among the HBsAg negative/antiHBc positive donations from a highly HIV prevalent region of India.
  
  
  METHODS
  A total of 729 HBsAg negative donor units were included in this study. Surface gene and precore region were amplified by in house nucleic acid test (NAT) for detection of occult HBV infection and surface gene was analyzed after direct sequencing.
  
  
  RESULTS
  A total of 220 (30.1%) HBsAg negative donors were antiHBc positive, of them 66 (30%) were HBV DNA positive by NAT. HBV DNA positivity among 164 antiHBc only group, was 27.1% and among 40 antiHBs positive group was 30.0%. HBV/D (93.3%) was predominant and prevalence of both HBV/C and HBV/A was 3.3%. Single or multiple amino acids substitutions were found in 95% samples.
  
  
  CONCLUSIONS
  Thus, a considerable number of HBV infected donors remain undiagnosed, if only HBsAg is used for screening. Addition of antiHBc testing for donor screening, although will lead to rejection of a large number of donor units, will definitely eliminate HBV infected donations and help in reducing HBV transmission with its potential consequences, especially among the immunocompromised population. The HBV genetic diversity found in this donor population are in accordance with other parts of India.
authors.affiliation: ICMR Virus Unit, Kolkata, ID & BG Hospital Campus, and Department of Chemistry, Jadavpur University, Kolkata, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Panigrahi
authors.forename: Avik
authors.initials: A
authors.lastname: Biswas
authors.forename: Sibnarayan
authors.initials: S
authors.lastname: Datta
authors.forename: Arup
authors.initials: A
authors.lastname: Banerjee
authors.forename: Partha K
authors.initials: PK
authors.lastname: Chandra
authors.forename: Pradip K
authors.initials: PK
authors.lastname: Mahapatra
authors.forename: Bharat
authors.initials: B
authors.lastname: Patnaik
authors.forename: Sekhar
authors.initials: S
authors.lastname: Chakrabarti
authors.forename: Runu
authors.initials: R
authors.lastname: Chakravarty
mesh_terms: D000328:Adult; D001782:Blood Donors; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D006509:Hepatitis B / Q000175:diagnosis* / Q000453:epidemiology*; D006510:Hepatitis B Antibodies / Q000097:blood*; D006512:Hepatitis B Core Antigens / Q000276:immunology; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods; D021141:Nucleic Acid Amplification Techniques / Q000379:methods*; D015995:Prevalence; D014773:Virology / Q000379:methods*
chemical_list: D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens
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