title: The diversity of chronic hepatitis B virus infections within blood donors in England and North Wales 2005 through 2010.
abstract: BACKGROUND
  In 2010 hepatitis B virus (HBV) was the most frequently detected infection in UK blood donation screening, typically found in first-time, male, chronically infected donors born abroad. To date there has been no comprehensive characterization of the virologic profile of these infections.
  
  
  METHODS
  Epidemiologic and serologic data were collected retrospectively for 344 chronically HBV-infected blood donors identified from July 2005 to June 2010. Additional laboratory testing was carried out to determine the HBV genotype, viral load, and prevalence of clinically significant mutations and to detect hepatitis delta virus (HDV) coinfection.
  
  
  RESULTS
  Five HBV genotypes (A-E) were found, Genotypes D (45%), A (20%), and E (20%) were the most prevalent. A strong association was seen between genotype and donor ethnicity (p < 0.001) and between genotype and place of residence (p = 0.006). Clinically significant mutations were observed across hepatitis B surface antigen (17%), basal core promoter (25%) and precore (78%) regions. An antiviral resistance profile was identified in one donor. Evidence of HDV coinfection was found in 2% of donors.
  
  
  CONCLUSIONS
  The data show the diversity of HBV in asymptomatic chronic infections detected in blood donors in England and North Wales and demonstrates the presence of mutations which may impact on disease. The global nature of these infections and the inability to identify chronically infected donors before donation highlights the importance of using screening assays capable of detecting a broad range of genotypes and mutations. Furthermore, the integration of the virologic and demographic data allows us to more accurately construct a profile of our chronically HBV-infected blood donors.
authors.affiliation: National Transfusion Microbiology Laboratories, NHS Blood and Transplant/Health Protection Agency Epidemiology Unit, Clinical Transfusion Microbiology, National Transfusion Microbiology Reference Laboratory, NHS Blood and Transplant; Blood Borne Virus Unit, Viral Reference Department, Microbiology Services, Health Protection Agency, Colindale, London, UK.
authors.forename: Gillian K
authors.initials: GK
authors.lastname: Rosenberg
authors.forename: Sam
authors.initials: S
authors.lastname: Lattimore
authors.forename: Susan R
authors.initials: SR
authors.lastname: Brailsford
authors.forename: Patricia E
authors.initials: PE
authors.lastname: Hewitt
authors.forename: Kate I
authors.initials: KI
authors.lastname: Tettmar
authors.forename: Alan D
authors.initials: AD
authors.lastname: Kitchen
authors.forename: Samreen
authors.initials: S
authors.lastname: Ijaz
authors.forename: Richard S
authors.initials: RS
authors.lastname: Tedder
mesh_terms: D000328:Adult; D001782:Blood Donors / Q000706:statistics & numerical data*; D004739:England / Q000453:epidemiology; D005260:Female; D014644:Genetic Variation; D005838:Genotype; D006514:Hepatitis B Surface Antigens / Q000097:blood / Q000235:genetics / Q000276:immunology; D006515:Hepatitis B virus / Q000145:classification / Q000235:genetics* / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000453:epidemiology* / Q000235:genetics / Q000276:immunology / Q000821:virology*; D006801:Humans; D008297:Male; D016036:Seroepidemiologic Studies; D014852:Wales / Q000453:epidemiology
chemical_list: D006514:Hepatitis B Surface Antigens