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Udvardy M, Illés Á, Gergely L, Pinczés LI, Magyari F, Simon Z. Transfusion-Transmitted Disorders 2023 with Special Attention to Bone Marrow Transplant Patients. Pathogens 2023; 12:901. [PMID: 37513748 PMCID: PMC10383292 DOI: 10.3390/pathogens12070901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023] Open
Abstract
Transfusion medicine is traditionally a strong/fundamental part of clinical practice, saving hundreds of millions of lives. However, blood-borne or transmitted infections are a well-known and feared possibility, a risk we relentlessly mitigate. Pathogens are continuously and rather quickly changing, so during the last decade, many, sometimes exotic, new pathogens and diseases were recorded and analyzed, and some of them were proved to be transmitted with transfusions. Blood or blood component transfusions are carried out after cautious preparative screening and inactivation maneuvers, but in some instances, newly recognized agents might escape from standard screening and inactivation procedures. Here, we try to focus on some of these proven or potentially pathogenic transfusion-transmitted agents, especially in immunocompromised patients or bone marrow transplantation settings. These pathogens are sometimes new challenges for preparative procedures, and there is a need for more recent, occasionally advanced, screening and inactivation methods to recognize and eliminate the threat a new or well-known pathogen can pose. Pathogen transmission is probably even more critical in hemophiliacs or bone marrow transplant recipients, who receive plasma-derived factor preparations or blood component transfusions regularly and in large quantities, sometimes in severely immunosuppressed conditions. Moreover, it may not be emphasized enough that transfusions and plasma-derived product administrations are essential to medical care. Therefore, blood-borne transmission needs continued alertness and efforts to attain optimal benefits with minimized hazards.
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Affiliation(s)
- Miklós Udvardy
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Árpád Illés
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Lajos Gergely
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - László Imre Pinczés
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Ferenc Magyari
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Zsófia Simon
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
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Valcke B, Vercauteren K, Padalko E, Verhofstede C, D'Herde K, Willaert W. Screening algorithms for HBV, HCV, HIV and syphilis in an anatomical donation program. Ann Anat 2021; 239:151805. [PMID: 34265386 DOI: 10.1016/j.aanat.2021.151805] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Users of anatomical donors are at risk of exposure to bloodborne pathogens. This study evaluated screening algorithms for hepatitis B and C virus, human immunodeficiency virus and Treponema pallidum during donor allocation and assessed the impact of postmortem time on hemolysis and how hemolysis affects test results and donor discard rate. METHODS From 2011 to 2018, demographic data of anatomical donors, time of postmortem blood sampling, presence of sample hemolysis, serological test results (negative; active infection; false reactive screening test; historic infection; inconclusive; technically impracticable) and the actual donor allocation were collected. RESULTS Donors (n = 537) had a mean age of 77.53 ± 13.67 (24-103) year. Nine (1.68%) had laboratory test results indicative for active infection for hepatitis B (n = 1) and C virus (n = 2), human immunodeficiency virus (n = 5) and T. pallidum (n = 1). Negative screenings ranged from 74.67 to 97.58%, depending on the pathogen. According to the original screening algorithms, 479 (89.20%) donors should have been accepted. In practice, a donor acceptance rate of 91.20% was found. Analysis of potential donor allocation interpretation obstacles resulted in simplification of the in-house laboratory testing algorithms and addition of a nucleic acid test to increase the reliability for identification of active (acute) human immunodeficiency virus infection. Hemolysis was more common when sampling was performed more than 24 h after death (p < 0.001). Hemolytic samples more frequently showed a reactive or indeterminate human immunodeficiency virus test result (p < 0.001). Screening for human immunodeficiency virus and T. pallidum was technically more impracticable when hemolysis was present (p = 0.042 and p = 0.003, respectively). Donors with hemolytic blood samples were more often discarded (46.88%) compared to bodies with non-hemolytic samples (6.32%) (p < 0.001). CONCLUSIONS Despite the implementation of donor screening algorithms, a significant number of bodies have an inconsistent allocation. New algorithms, to be evaluated in future research, were suggested. Early postmortem blood sampling is key as hemolysis can influence certain test results and donor allocation.
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Affiliation(s)
- Brecht Valcke
- Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Koen Vercauteren
- Clinical Virology Unit, Clinical Reference Laboratory, Institute of Tropical Medicine, Kronenburgstraat 43, 2000 Antwerp, Belgium
| | - Elizaveta Padalko
- Laboratory of Medical Microbiology, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Chris Verhofstede
- Aids Reference Laboratory, Department of Diagnostic Sciences, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Katharina D'Herde
- Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Wouter Willaert
- Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
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Pruß A, Chandrasekar A, Sánchez-Ibáñez J, Lucas-Samuel S, Kalus U, Rabenau HF. Algorithms for the Testing of Tissue Donors for Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus. Transfus Med Hemother 2021; 48:12-22. [PMID: 33708048 DOI: 10.1159/000513179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 11/18/2020] [Indexed: 12/11/2022] Open
Abstract
Background Although transmission of pathogenic viruses through human tissue grafts is rare, it is still one of the most serious dreaded risks of transplantation. Therefore, in addition to the detailed medical and social history, a comprehensive serologic and molecular screening of the tissue donors for relevant viral markers for human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) is necessary. In the case of reactive results in particular, clear decisions regarding follow-up testing and the criteria for tissue release must be made. Methods Based on the clinical relevance of the specific virus markers, the sensitivity of the serological and molecular biological methods used and the application of inactivation methods, algorithms for tissue release are suggested. Results Compliance with the preanalytical requirements and assessment of a possible hemodilution are mandatory requirements before testing the blood samples. While HIV testing follows defined algorithms, the procedures for HBV and HCV diagnostics are under discussion. Screening and decisions for HBV are often not as simple, e.g., due to cases of occult HBV infection, false-positive anti-HBc results, or early window period positive HBV NAT results. In the case of HCV diagnostics, modern therapies with direct-acting antivirals, which are often associated with successful treatment of the infection, should be included in the decision. Conclusion In HBV and HCV testing, a high-sensitivity virus genome test should play a central role in diagnostics, especially in the case of equivocal serology, and it should be the basis for the decision to release the tissue. The proposed test algorithms and decisions are also based on current European recommendations and standards for safety and quality assurance in tissue and cell banking.
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Affiliation(s)
- Axel Pruß
- Institute of Transfusion Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Akila Chandrasekar
- National Health Service Blood and Transplant (NHSBT), Liverpool, United Kingdom
| | - Jacinto Sánchez-Ibáñez
- Tissue Establishment and Cryobiology Unit, University Hospital A Coruña, A Coruña, Spain
| | - Sophie Lucas-Samuel
- Safety and Quality Department, Agence de la Biomédecine, Saint-Denis Cedex, France
| | - Ulrich Kalus
- Institute of Transfusion Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
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Larscheid G, Schulz T, Herbst H, Trögel T, Eulert S, Pruß A, Schroeter J. Comparison of Total Immunoglobulin G in Ante- and Postmortem Blood Samples from Tissue Donors. Transfus Med Hemother 2021; 48:32-38. [PMID: 33708050 DOI: 10.1159/000513662] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 12/02/2020] [Indexed: 11/19/2022] Open
Abstract
Background A serology testing for infectious diseases (HIV, hepatitis B and C, syphilis) is mandatory in tissue donors. In many donors postmortem blood is the only sample available. Even though serological tests and nucleic acid amplification tests (NAT) used are validated for postmortem blood, a characterization of those blood samples is not yet established. We therefore investigated the total immunoglobulin G (IgG) content in postmortem blood of tissue donors and compared it to a corresponding antemortem blood sample. Methods Ante- and postmortem blood samples were obtained from 100 consecutive tissue donors. The total IgG of all samples was measured using an immune-turbidometric test on the AU 480 Chemistry Analyzer (Beckman Coulter). Results The mean total IgG concentration of antemortem blood samples from all 100 donors was 8.9 g/L ± 3.7 g/L (median 8.9 g/L, range 1.5 to 23.8 g/L). In 80 donors the IgG concentration in the antemortem blood sample was within the normal range with values ≥6 g/L (mean 10.0 g/L ± 3.3 g/L, median 9.3 g/L,). The total IgG concentration of the postmortem blood samples was lower with 7.2 g/L ± 3.2 g/L (median 6.7 g/L, range 0.6 to 18.2 g/L). The difference between the values of the antemortem and postmortem blood samples was 1.7 g/L ± 2.6 g/L (16.3%) (median 1.6 g/L, range -7.7 to 10.1 g/L). In 36 donors this difference was less than 10%, in 23 it was between 10 and 25%, in 33 between 26 and 50%, and in 8 over 50%. In 57 donors the total IgG in the postmortem blood sample was within the normal range with ≥6 g/L, in 53 of them also the value of the antemortem blood sample was within the normal range. No correlation for total IgG was found regarding the donor characteristics (age, sex, disease) and the sample characteristics (hemolysis, postmortem time). Conclusion Total IgG values in antemortem samples were below the lower limit of 6 g/L in 20% of the cases. Total IgG was significantly lower in the postmortem samples compared to the antemortem samples, while 57% were still above the lower limit. No correlation with the postmortem time could be found. This lowered IgG levels should be payed attention to when using postmortem blood for infectious serology testing. Additional NAT testing should be considered.
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Affiliation(s)
- Gudrun Larscheid
- Department of Pathology, Vivantes Klinikum Neukölln, Berlin, Germany
| | - Tino Schulz
- University Tissue Bank, Institute of Transfusion Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Hermann Herbst
- Department of Pathology, Vivantes Klinikum Neukölln, Berlin, Germany
| | - Tina Trögel
- Department of Pathology, Vivantes Klinikum Neukölln, Berlin, Germany
| | - Sascha Eulert
- German Rheumatism Research Center, a Leibniz Institute, Epidemiology Unit, Berlin, Germany
| | - Axel Pruß
- University Tissue Bank, Institute of Transfusion Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jan Schroeter
- University Tissue Bank, Institute of Transfusion Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Li N, Li Y, Gao H, Li J, Ma X, Liu X, Gong P, Cui X, Li Y. Forkhead-box A3 (FOXA3) represses cancer stemness and partially potentiates chemosensitivity by targeting metastasis-associated in colon cancer 1 (MACC1) signaling pathway in colorectal cancer cells. Curr Cancer Drug Targets 2020; 21:CCDT-EPUB-112119. [PMID: 33292133 DOI: 10.2174/1568009620666201207150632] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/13/2020] [Accepted: 10/14/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND The major challenge to the treatment of advanced colorectal cancer (CRC) is persistent occurrence of chemoresistance. One of the established etiologies is the existence of cancerstem-like cells (CSCs) using which tumors resist to external therapeutic challenges. OBJECTIVE The forkhead-box A3 (FOXA3) is a potent transcription factor that potentiates the acquisition and maintenance of stemness fate in many physiological systems. However, its effect on cancer stemness, particularly treatment, has not been explored in CRC, forming the basis of the current study. METHODS FOXA3 expression in oxaliplatin-resistant CRC tissues and cells was evaluated using RT-qPCR. Effects of FOXA3 manipulation on sensitivity to oxaliplatin were assessed using WST-1, apoptotic ELISA, colony formation and xenograft model. Effects of FOXA3 alteration on CSCs were determined using tumor sphere assay and CD44 staining. Transcriptional regulation of MACC1 by FOXA3 was studied using ChIP, Co-IP and luciferase reporter assay. RESULTS FOXA3 expression was significantly reduced in tumor samples from oxaliplatin-non-responsive patients compared with that in tumor samples from oxaliplatin-sensitive patients. This downregulation of FOXA3 expression predicted a poor post-chemotherapy overall- or disease-free survival in our 117-patient cohort. FOXA3 down-regulation significantly enhanced cell survival and stem-like properties, thus rendering the CRC cells unresponsiveness to oxaliplatin-induced cell death. Mechanistically, the anti-neoplasic effect of FOXA3 was mediated mainly through transcriptional repression of metastasis-associated in colon cancer 1 (MACC1) in oxaliplatin-resistant CRC cells. CONCLUSION Our findings establish FOXA3 as a potent tumor suppressor in CRC, which may disrupt the maintenance of stemness and modulate sensitivity to oxaliplatin by inhibiting the transcription of MACC1 within CRC cells.
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Affiliation(s)
- Na Li
- Cancer center of Suining Central Hospital, Suining 629000. China
| | - Yun Li
- Department of Medical Oncology, First Affiliated Hospital of Medical College of Shihezi University, Shihezi 832000, Xinjiang Uygur Autonomous Region. China
| | - Hongbo Gao
- Radionuclide Diagnosis and Treatment Center, Beijing Nuclear Industry Hospital, Beijing 100045. China
| | - Jing Li
- Department of Medical Oncology, First Affiliated Hospital of Medical College of Shihezi University, Shihezi 832000, Xinjiang Uygur Autonomous Region. China
| | - Xiaoping Ma
- Department of Medical Oncology, First Affiliated Hospital of Medical College of Shihezi University, Shihezi 832000, Xinjiang Uygur Autonomous Region. China
| | - Xiaomei Liu
- Cancer center of Suining Central Hospital, Suining 629000. China
| | - Ping Gong
- Department of Medical Oncology, First Affiliated Hospital of Medical College of Shihezi University, Shihezi 832000, Xinjiang Uygur Autonomous Region. China
| | - Xiaobin Cui
- Department of Pathology, Medical College of Shihezi University, Shihezi 832000, Xinjiang Uygur Autonomous Region. China
| | - Yong Li
- Department of Radiology, Suining Central Hospital, Suining 629000. China
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Assad DX, Mascarenhas ECP, Normando AGC, Chardin H, Barra GB, Pratesi R, Nóbrega YKDM, Acevedo AC, Guerra ENS. Correlation between salivary and serum CA15-3 concentrations in patients with breast cancer. Mol Clin Oncol 2020; 13:155-161. [PMID: 32714539 PMCID: PMC7366245 DOI: 10.3892/mco.2020.2062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 04/30/2020] [Indexed: 12/24/2022] Open
Abstract
The early detection of breast cancer enables the use of less aggressive treatment and increases patient survival. The transmembrane glycoprotein mucin 1, which is also known as cancer antigen 15-3 (CA15-3), is aberrantly glycosylated and overexpressed in a variety of epithelial cancers, and serves a crucial role in the progression of the disease. CA15-3 is currently used as a marker of breast cancer. In the present study, CA15-3 concentrations in saliva and blood of patients with breast cancer were evaluated to test new assays to detect salivary CA15-3 in addition to ELISA and its diagnostic value. To the best of our knowledge, there are no previous reports of the use of chemiluminescence assay (CLIA) and electrochemiluminescence assay (ECLIA) in saliva. Saliva and blood were collected on the same day from patients with breast cancer (n=26) and healthy controls (n=28). For each subject, the level of serum CA15-3 was measured using ECLIA, and the level of salivary CA15-3 was measured using ECLIA, CLIA and enzyme-linked immunosorbent assay (ELISA). ELISA and CLIA were able to detect CA15-3 in saliva; however, ECLIA could not detect salivary CA15-3. There was no significant difference between the mean serum and salivary CA15-3 levels in patients with breast cancer or healthy controls. The levels of CA15-3 were highest for luminal breast cancer subtypes and stage IV cases. A moderate correlation was observed between salivary and serum CA15-3 levels as measured by ELISA in breast cancer patients (r=0.56; P=0.0047). The results demonstrated that ECLIA was not a good method to detect salivary CA15-3, although it is the gold standard for detecting serum CA15-3. The presence of CA15-3 in saliva was confirmed, and this will be useful in future research. Further investigations are necessary to confirm the ability to detect salivary CA15-3 and its correlation with serum CA15-3.
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Affiliation(s)
- Daniele Xavier Assad
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasília Campus Universitário Darcy Ribeiro, Brasília, DF 70910-900, Brazil.,Medical Oncology Department, Hospital Sírio-Libanês, Brasília, DF 70200-730, Brazil
| | - Elisa Cançado Porto Mascarenhas
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasília Campus Universitário Darcy Ribeiro, Brasília, DF 70910-900, Brazil.,Department Medical Oncology, Cettro-Centro de Câncer de Brasília, Brasilia, DF 70710-904, Brazil
| | - Ana Gabriela Costa Normando
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasília Campus Universitário Darcy Ribeiro, Brasília, DF 70910-900, Brazil
| | - Hélène Chardin
- Department of Analytical, Bioanalytical Sciences and Miniaturization (LSABM), ESPCI Paris, PSL Research University, Paris 75005, France.,Faculty of Dental Surgery, Paris Descartes Sorbonne Paris Cité University, Paris 92120, France
| | | | - Riccardo Pratesi
- Interdisciplinary Laboratory of Biosciences and Celiac Disease Research Center, School of Medicine, University of Brasilia, Brasília, DF 70910-900, Brazil
| | - Yanna Karla de Medeiros Nóbrega
- Applied Analysis Laboratory, Department of Pharmaceutical Sciences, Health Sciences Faculty, University of Brasília, Brasília, DF 70910-900, Brazil
| | - Ana Carolina Acevedo
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasília Campus Universitário Darcy Ribeiro, Brasília, DF 70910-900, Brazil
| | - Eliete Neves Silva Guerra
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasília Campus Universitário Darcy Ribeiro, Brasília, DF 70910-900, Brazil
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Ribeiro VST, Raboni SM, Suss PH, Cieslinski J, Kraft L, Dos Santos JS, Pereira L, Tuon FF. Detection and quantification of human immunodeficiency virus and hepatitis C virus in cadaveric tissue donors using different molecular tests. J Clin Virol 2019; 121:104203. [PMID: 31715525 DOI: 10.1016/j.jcv.2019.104203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 10/13/2019] [Accepted: 10/17/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Tissues from cadaveric donors are used in several clinical circumstances, and the transmission of infectious diseases has been reported. Cadaveric donor (CD) blood sample analysis is challenging due to its poor quality. However, studies have demonstrated the usefulness of molecular based methods, and the lack of studies using available commercial molecular tests was reported. OBJECTIVE The aim of this study was to evaluate the performance, specificity, sensitivity, and accuracy of different commercial molecular tests for HIV and HCV detection and quantification in CD through spiked samples. STUDY DESIGN 20 CD and 20 blood donor samples were tested using 1,000 copies/mL and 1,000 IU/mL of lyophilized standards of HIV and HCV, respectively. Samples were analyzed by different molecular kits: XPERT HCV Viral Load and HIV-1 (Cepheid), COBAS® TaqMan® HIV-1 and COBAS® TaqMan® HCV Test, v2.0 (Roche), and artus® HI Virus-1 QS-RGQ and artus® HCV RG RT-PCR Kit (Qiagen). RESULTS HIV and HCV in CD were detected by RT-PCR-based quantitative kits. The tests performed by the Cepheid and the Roche kits showed the most accurate, sensitive and specific results, however, a wide variability between the assays and kits was observed. The Qiagen kits did not demonstrate satisfactory results. CONCLUSIONS CD evaluation showed great variability. The Cepheid and Roche kits were more sensitive for detecting HIV on CD and Cepheid was the most efficient kit for HCV quantification in CD. The Roche and Cepheid kits can be used to screen tissue donors for HIV and HCV.
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Affiliation(s)
- Victoria Stadler Tasca Ribeiro
- Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR, 80215-901, Brazil
| | - Sonia Mara Raboni
- Laboratory of Molecular Biology of Infectious Diseases, Universidade Federal do Paraná, Curitiba, PR, 80060-900, Brazil
| | - Paula Hansen Suss
- Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR, 80215-901, Brazil
| | - Juliette Cieslinski
- Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR, 80215-901, Brazil
| | - Letícia Kraft
- Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR, 80215-901, Brazil
| | - Jucélia Stadinicki Dos Santos
- Laboratory of Molecular Biology of Infectious Diseases, Universidade Federal do Paraná, Curitiba, PR, 80060-900, Brazil
| | - Luciane Pereira
- Laboratory of Molecular Biology of Infectious Diseases, Universidade Federal do Paraná, Curitiba, PR, 80060-900, Brazil
| | - Felipe Francisco Tuon
- Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR, 80215-901, Brazil.
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8
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Evaluation of occult hepatitis B infection in tissue donors: a multicenter analysis in Spain. Cell Tissue Bank 2019; 20:513-526. [PMID: 31451994 DOI: 10.1007/s10561-019-09784-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 08/21/2019] [Indexed: 12/31/2022]
Abstract
Traditionally, when antibody to the Hepatitis B core antigen (anti-HBc) and antibody to the Hepatitis B surface antigen (anti-HBs) are positive, the donor is considered suitable. However, the literature contains cases with this profile and circulating hepatitis B virus DNA. The aim of the study is to analyze the incidence of occult hepatitis B virus infection (OBI). Retrospective data were evaluated for deceased tissue donors in ten Tissue Establishments (Spain) during 2017. The data included demographic data and the serological markers for hepatitis B that each tissue establishment performed. A total number of 1933 tissue donors were evaluated. A total of 180 donors were excluded: 6 (0.3%) with Hepatitis B surface antigen (HBs positive), and 174 in which DNA testing was not performed. Anti-HBc was positive in 175 donors (10%), in which anti-HBs was negative in 30 (17.1%) and positive in 145 (82.9%). In total, 27 donors with DNA positive (1.5%) were found, of which 3 of 117 donors (1.7%) showed anti-HBc negative and anti-HBs positive (> 10 IU/ml), 4 of 30 donors (13.3%) showed anti-HBc positive and anti-HBs negative and 20 of 145 donors (13.8%) showed both anti-HBc and anti-HBs positive. The highest probability of finding DNA occurs when anti-HBc is positive, regardless of the presence of anti-HBs. In our study, the probability of OBI was 1.5%. The classic concept that when anti-HBc and anti-HBs are positive (even with a titer of over 100 IU/ml) the donor can be accepted should, therefore, be reconsidered, and DNA testing should be mandatory.
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9
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Cilliers K, Muller CJF, Page BJ. Human immunodeficiency virus in cadavers: A review. Clin Anat 2019; 32:603-610. [PMID: 30811656 DOI: 10.1002/ca.23358] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 02/21/2019] [Accepted: 02/24/2019] [Indexed: 11/07/2022]
Abstract
Millions of people are infected with human immunodeficiency virus (HIV); however, limited research focuses on post-mortem HIV detection. Post-mortem HIV testing is vital because medical records are not always available, and the HIV status can be unknown. The aims of this study were to review the available literature and determine the most efficient HIV test for post-mortem samples, the optimal tissue or bodily fluid to be tested, and the duration that HIV remains reliably detectable. A literature search was conducted using PubMed and Google Scholar. Terms were related to HIV (HIV detection, HIV testing, HIV prevalence) and deceased individuals (post-mortem, cadaver, deceased, organ donor). Inclusion criteria included English studies, or articles with at least an English abstract, while review articles were excluded. From this literature search, 43 studies were applicable. These studies most commonly used enzyme-linked immunosorbent assay and Western blot as screening and confirmation tests, respectively. As for the optimal tissue or bodily fluid, serum remained the golden standard, while testing skin seemed promising. HIV remains detectable in the body up to 58 days after death, although few studies tested samples after 48 h. Knowledge of the HIV status can be beneficial in the case of accidental exposure and can create a range of possible research opportunities on the effects of HIV in different organ systems. This review outlined several gaps in the current literature and future studies should investigate these gaps because this information can be relevant to numerous professions. Clin. Anat. 32:603-610, 2019. © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
- Karen Cilliers
- Division of Clinical Anatomy, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Western Cape, South Africa
| | - Christo J F Muller
- Biomedical Research and Innovation Platform (BRIP), South African Medical Research Council, Tygerberg, Western Cape, South Africa.,Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Western Cape, South Africa
| | - Benedict J Page
- Division of Clinical Anatomy, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Western Cape, South Africa
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10
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Gentile C, Van Deerlin VM, Goldberg DS, Reese PP, Hasz RD, Abt P, Blumberg E, Farooqi MS. Hepatitis C virus genotyping of organ donor samples to aid in transplantation of HCV-positive organs. Clin Transplant 2017; 32. [PMID: 29220079 DOI: 10.1111/ctr.13172] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2017] [Indexed: 02/06/2023]
Abstract
Given the availability of new highly efficacious anti-HCV therapies, some clinicians have advocated for wider use of kidneys from hepatitis C virus-positive (HCV+) donors, including transplanting them into HCV-negative recipients. As treatment regimens for HCV are commonly guided by genotype, pretransplant HCV genotyping of tissue donors would be beneficial. To our knowledge, donor HCV genotyping has never been reported. We retrieved archived frozen plasma samples for 17 previous organ donors through a local organ procurement organization. We performed HCV genotyping using the eSensor HCVg Direct Test (GenMark Diagnostics) and also by Sanger sequencing, for confirmation (Retrogen). In addition, viral loads were measured using the COBAS AmpliPrep/TaqMan system (Roche Diagnostics). We found that most of the samples (n = 14) were HCV Genotype 1a with the remainder being Genotype 2b (n = 1) or Genotype 3 (n = 2). All genotyping results were concordant with Sanger sequencing. The average HCV viral load in the sample group was ~ 1.6 million IU/mL (range: ~16 000 IU/mL to 7 million IU/mL). We demonstrate that viral RNA from organ donor plasma can be successfully genotyped for HCV. This ability suggests that transplantation of HCV+ kidneys into HCV-negative recipients, followed by genotype-guided antiviral therapy, could be feasible.
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Affiliation(s)
- Caren Gentile
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Vivianna M Van Deerlin
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David S Goldberg
- Division of Gastroenterology, University of Pennsylvania, Philadelphia, PA, USA.,Department of Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
| | - Peter P Reese
- Department of Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.,Renal-Electrolyte and Hypertension Division, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Peter Abt
- Division of Transplant Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Emily Blumberg
- Infectious Diseases Division, University of Pennsylvania, Philadelphia, PA, USA
| | - Midhat S Farooqi
- Department of Pathology and Laboratory Medicine, Children's Mercy Hospital, Kansas City, MO, USA
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