title: Occult hepatitis B virus infection as a cause of posttransfusion hepatitis in patients with cancers.
abstract: BACKGROUND
  Prevalence of hepatitis B virus (HBV) infection is increased in patients of cancer with increased mortality. Multiple transfusions of blood and blood-related products are a potential source.
  
  
  OBJECTIVE
  This study aims to assess the incidence of hepatitis B surface antigen (HBsAg) seroconversion in cancer patients receiving transfusion of blood or blood-related products and identify possible reasons for infection in these patients.
  
  
  METHODS
  Patients of cancer receiving blood products, who were HBsAg-, anti-hepatitis B core (HBc)-, and HBV DNA-negative prior to transfusion, were tested for HBsAg by ELISA at 6, 12, and 24 weeks after the last transfusion. Blood donors were screened for HBsAg by ELISA.
  
  
  RESULTS
  Twenty of 3,600 (0.56 %) blood donors tested positive for HBsAg and were rejected. Nine of 150 (6 %) cancer patients became HBsAg-positive posttransfusion which included seven patients who presented with acute hepatitis B and other two patients who remained HBsAg-positive without hepatitis. In 6/9 (66.6 %) patients, HBsAg positivity was related to blood transfusion as their corresponding blood donors on retesting the stored samples were positive for anti-HBc antibody and HBV DNA. In other three patients, the cause of their HBsAg positivity could not be ascertained.
  
  
  CONCLUSIONS
  Occult HBV infection in blood donors is a potential source of posttransfusion HBV infection in recipients. Anti-HBc antibody and HBV DNA should be tested in blood donors especially when blood is given to cancer patients receiving chemotherapy.
authors.affiliation: Department of Gastroenterology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Kashmir 190 011, India. jassi_win@rediffmail.com
authors.forename: Jaswinder Singh
authors.initials: JS
authors.lastname: Sodhi
authors.forename: Nayeem
authors.initials: N
authors.lastname: Wani
authors.forename: Samoon
authors.initials: S
authors.lastname: Jeelani
authors.forename: Sajad
authors.initials: S
authors.lastname: Geelani
authors.forename: Fehmida
authors.initials: F
authors.lastname: Akhtar
authors.forename: Gul
authors.initials: G
authors.lastname: Javid
authors.forename: Gh Nabi
authors.initials: GN
authors.lastname: Yattoo
authors.forename: Altaf
authors.initials: A
authors.lastname: Shah
authors.forename: Gh Mohd
authors.initials: GM
authors.lastname: Gulzar
authors.forename: Mushtaq A
authors.initials: MA
authors.lastname: Khan
authors.forename: Shaheena
authors.initials: S
authors.lastname: Parveen
authors.forename: Riyaz-U
authors.initials: RU
authors.lastname: Saif
authors.forename: Abid
authors.initials: A
authors.lastname: Showkat
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D058731:Blood Safety; D002648:Child; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology* / Q000276:immunology / Q000635:transmission; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D016036:Seroepidemiologic Studies; D065227:Transfusion Reaction; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens