title: Detection of occult hepatitis B and window period infection among blood donors by individual donation nucleic acid testing in a tertiary care center in South India.
abstract: With the introduction of highly sensitive hepatitis B surface antigen immunoassay, transfusion associated HBV infection have reduced drastically but they still tend to occur due to blood donors with occult hepatitis B infection (OBI) and window period (WP) infection. Sera from, 24338 healthy voluntary blood donors were screened for HBsAg, HIV and HCV antibody using Vitros Enhanced Chemiluminescent Immunoassay. The median age of the donor population was 30 (range 18-54) with male preponderance (98%). All serologically negative samples were screened by nucleic acid testing (NAT) for viral DNA and RNA. NAT-positive samples were subjected to discriminatory NAT for HBV, HCV, and HIV and all samples positive for HBV DNA were tested for anti-HBc, anti-HBs, HBeAg. Viral load was determined using artus HBV RG PCR Kit. Of the 24,338 donors screened, 99.81% (24292/24338) were HBsAg negative of which NAT was positive for HBV DNA in 0.0205% (5/24292) donors. Four NAT positive donors had viral load of <200 IU/ml making them true cases of OBI. One NAT positive donor was negative for all antibodies making it a case of WP infection. Among OBI donors, 75% (3/4) were immune and all were negative for HBeAg. Precise HBV viral load could not be determined in all (5/5) NAT positive donors due to viral loads below the detection limit of the artus HBV RG PCR Kit. The overall incidence of OBI and WP infections was found to be low at 1 in 6503 and 1 in 24214 donations, respectively. More studies are needed to determine the actual burden of WP infections in Indian blood donors.
authors: a Amrita Institute of Medical Sciences and Research Center , Amrita Vishwa Vidyapeetham (Amrita University) , Ponekkara, Cochin , Kerala , India.
authors: Cinzia S
authors: CS
authors: Keechilot
authors: b Department of Transfusion Medicine , Amrita Institute of Medical Sciences and Research Center, Amrita Vishwa Vidyapeetham (Amrita University) , Ponekkara, Cochin , Kerala , India.
authors: Veena
authors: V
authors: Shenoy
authors: c Department of Microbiology , Amrita Institute of Medical Sciences and Research Center, Amrita Vishwa Vidyapeetham (Amrita University) , Ponekkara, Cochin , Kerala , India.
authors: Anil
authors: A
authors: Kumar
authors: d Department of Molecular Biology , Amrita Institute of Medical Sciences and Research Center, Amrita Vishwa Vidyapeetham (Amrita University) , Ponekkara, Cochin , Kerala , India.
authors: Lalitha
authors: L
authors: Biswas
authors: e Center for Nanoscience and Molecular medicine , Amrita Institute of Medical Sciences and Research Center, Amrita Vishwa Vidyapeetham (Amrita University) , Ponekkara, Cochin , Kerala , India.
authors: Sukhithasri
authors: S
authors: Vijayrajratnam
authors: c Department of Microbiology , Amrita Institute of Medical Sciences and Research Center, Amrita Vishwa Vidyapeetham (Amrita University) , Ponekkara, Cochin , Kerala , India.
authors: Kavitha
authors: K
authors: Dinesh
authors: f Department of Gastroenterology , Amrita Institute of Medical Sciences and Research Center, Amrita Vishwa Vidyapeetham (Amrita University) , Ponekkara, Cochin , Kerala , India.
authors: Prem
authors: P
authors: Nair
mesh_terms: D000293:Adolescent; D000328:Adult; D001782:Blood Donors; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D006509:Hepatitis B / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology*; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood*; D062606:Tertiary Care Centers; D065227:Transfusion Reaction; D019562:Viral Load; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D012367:RNA, Viral
keywords: Anti-HBc; HBV; Nucleic acid testing; Occult hepatitis B virus infection