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Mo Y, Jin F, Li D, Zou W, Zhong J, Tong Z, Wang W, Qian F. Prevalence and molecular characteristics of occult hepatitis B virus infection among blood donors in Huzhou City, eastern China. Gene 2024; 927:148718. [PMID: 38914243 DOI: 10.1016/j.gene.2024.148718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 05/23/2024] [Accepted: 06/20/2024] [Indexed: 06/26/2024]
Abstract
Occult hepatitis B virus (HBV) infection (OBI) is a significant challenge for HBV prevention and control. We investigated the prevalence and surface (S) gene mutations of OBI among blood donors in Huzhou City, eastern China. The hepatitis B surface antigen (HBsAg) was routinely screened among 44,256 blood donors. HBV-DNA was detected using the Roche cobas®system. Serum samples that were HBsAg negative and HBV-DNA positive were selected, and the HBV S gene was amplified and sequenced. HBV genotype and S gene mutations were analyzed. The OBI rate in these blood donors was 0.070 % (31/44,256). Among the blood donors with OBI, only two cases (2/31, 6.5 %) were anti-HBc negative. The S gene sequences of 28 samples were successfully obtained, and we found that HBV genotype C (21/28, 70 %) was predominant among blood donors with OBI. Most S gene mutations were associated with OBI, and the high frequency mutations included N40S, G44E, Q51R/P, T113A/S,T118K/M, P120Q/S/T, and Y161F/S. Notably, amino acid substitutions at some sites differed from those reported previously, such as Y72F, G102V, P127L, Q129P, and S143T. Additionally, six novel mutations (S31I/N/R, P46L, S58C, C76Y, Y200F/C, and I208T) that may be associated with OBI were found. OBI was detected in a certain proportion of blood donors in Huzhou City. S gene mutations play an important role in OBI development. Further research is required to explore the functions of novel S gene mutants in OBI pathogenesis. The findings of this study may provide important insights to prevent HBV transmission through blood transfusions.
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Affiliation(s)
- Yanping Mo
- Huzhou Center Blood Station, 577 Fenghuang Road, Huzhou, Zhejiang 313000, China
| | - Fang Jin
- Departmentof Precision Medicine, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, Huzhou, Zhejiang 313000, China; Huzhou Key Laboratory of Precision Medicine Research and Translation for Infectious Diseases, Huzhou Central Hospital, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, Huzhou, Zhejiang 313000, China
| | - Dongli Li
- Departmentof Precision Medicine, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, Huzhou, Zhejiang 313000, China; Huzhou Key Laboratory of Precision Medicine Research and Translation for Infectious Diseases, Huzhou Central Hospital, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, Huzhou, Zhejiang 313000, China
| | - Weihua Zou
- Department of Laboratory Medicine, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, Huzhou, Zhejiang 313000, China
| | - Jianfeng Zhong
- Huzhou Key Laboratory of Precision Medicine Research and Translation for Infectious Diseases, Huzhou Central Hospital, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, Huzhou, Zhejiang 313000, China; Department of Infectious Diseases, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, Huzhou, Zhejiang 313000, China
| | - Zhaowei Tong
- Huzhou Key Laboratory of Precision Medicine Research and Translation for Infectious Diseases, Huzhou Central Hospital, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, Huzhou, Zhejiang 313000, China; Department of Infectious Diseases, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, Huzhou, Zhejiang 313000, China
| | - Weihong Wang
- Huzhou Key Laboratory of Precision Medicine Research and Translation for Infectious Diseases, Huzhou Central Hospital, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, Huzhou, Zhejiang 313000, China; Department of Infectious Diseases, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, Huzhou, Zhejiang 313000, China
| | - Fuchu Qian
- Departmentof Precision Medicine, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, Huzhou, Zhejiang 313000, China; Huzhou Key Laboratory of Precision Medicine Research and Translation for Infectious Diseases, Huzhou Central Hospital, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, Huzhou, Zhejiang 313000, China.
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Satake M, Sugiyama M, Mizokami M, Tanaka J. Incidences of new hepatitis B infection and anti-hepatitis B core-negative occult hepatitis B infection among Japanese blood donors in relation to anti-hepatitis B surface antigen levels. J Med Virol 2024; 96:e29823. [PMID: 39039862 DOI: 10.1002/jmv.29823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 07/05/2024] [Accepted: 07/15/2024] [Indexed: 07/24/2024]
Abstract
A transfusion-transmitted hepatitis B virus (HBV) infection caused by blood only positive for anti-hepatitis B surface antigen (anti-HBs) was reported. Occult HBV infection (OBI) with sole anti-HBs among blood donors is an issue. The incidence of HBV infection among repeat blood donors was investigated with a detailed HBV infection phase, focusing on the influence of anti-HBs level. This study followed 3 435 653 donors for HBV DNA conversion over 4 years and 9 months. Infection phase was determined based on marker changes over DNA conversion. This study identified 115 hepatitis B surface antigen (HBsAg) conversions, 72 DNA-only conversions, and 15 DNA plus anti-hepatitis B core (anti-HBc) conversions among donors all negative for HBV DNA, HBsAg, and anti-HBc. Total incidence was 2.38/100 000 person-years (PY). None of these 202 new HBV infections arose in the group with anti-HBs titer ≥ 10 mIU/mL. In total, 30 anti-HBc-negative OBIs were identified (incidence; 0.35/100 000 PY); 7 showed typical secondary anti-HBs response, and 23 showed stable anti-HBc and anti-HBs levels at DNA conversion. The HBV infection-protective ability of anti-HBs ≥ 10 mIU/mL was reinforced. In addition to new infections, the blood donor population includes anti-HBc-positive- and negative OBI with immune reactions or abortive HBV infection.
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Affiliation(s)
- Masahiro Satake
- Blood Service Headquarters, Japanese Red Cross, Tokyo, Japan
| | - Masaya Sugiyama
- Department of Viral Pathogenesis and Controls, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masashi Mizokami
- Genome Medical Sciences Project, National Center for Global Health and Medicine, Tokyo, Japan
| | - Junko Tanaka
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Faddy HM, Osiowy C, Custer B, Busch M, Stramer SL, Dean MM, Acutt J, Viennet E, van de Laar T, Tsoi WC, Styles C, Kiely P, Margaritis A, Kwon SY, Qiu Y, Deng X, Lewin A, Jørgensen SW, Erikstrup C, Juhl D, Sauleda S, Camacho Rodriguez BA, Soto Coral LJC, Gaviria García PA, Oota S, O'Brien SF, Wendel S, Castro E, Navarro Pérez L, Harvala H, Davison K, Reynolds C, Jarvis L, Grabarczyk P, Kopacz A, Łętowska M, O'Flaherty N, Young F, Williams P, Burke L, Chua SS, Muylaert A, Page I, Jones A, Niederhauser C, Vermeulen M, Laperche S, Gallian P, Satake M, Addas-Carvalho M, Blanco S, Gallego SV, Seltsam A, Weber-Schehl M, Al-Riyami AZ, Al Maamari K, Alawi FB, Pandey HC, França RA, Charlewood R. An international review of the characteristics of viral nucleic acid-amplification testing (NAT) reveals a trend towards the use of smaller pool sizes and individual donation NAT. Vox Sang 2024; 119:745-751. [PMID: 38516962 DOI: 10.1111/vox.13617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/19/2024] [Accepted: 03/03/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND AND OBJECTIVES Nucleic acid-amplification testing (NAT) is used for screening blood donations/donors for blood-borne viruses. We reviewed global viral NAT characteristics and NAT-yield confirmatory testing used by blood operators. MATERIALS AND METHODS NAT characteristics and NAT-yield confirmatory testing used during 2019 was surveyed internationally by the International Society of Blood Transfusion Working Party Transfusion-Transmitted Infectious Diseases. Reported characteristics are presented herein. RESULTS NAT was mainly performed under government mandate. Human immunodeficiency virus (HIV), hepatitis C virus (HCV) and hepatitis B virus (HBV) NAT was performed on all donors and donation types, while selective testing was reported for West Nile virus, hepatitis E virus (HEV), and Zika virus. Individual donation NAT was used for HIV, HCV and HBV by ~50% of responders, while HEV was screened in mini-pools by 83% of responders performing HEV NAT. Confirmatory testing for NAT-yield samples was generally performed by NAT on a sample from the same donation or by NAT and serology on samples from the same donation and a follow-up sample. CONCLUSION In the last decade, there has been a trend towards use of smaller pool sizes or individual donation NAT. We captured characteristics of NAT internationally in 2019 and provide insights into confirmatory testing approaches used for NAT-yields, potentially benefitting blood operators seeking to implement NAT.
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Affiliation(s)
- Helen M Faddy
- School of Health, University of the Sunshine Coast, Petrie, Queensland, Australia
- Research and Development, Australian Red Cross Lifeblood, Brisbane, Queensland, Australia
| | - Carla Osiowy
- National Microbiology Laboratory, Public Health Agency of Canada, Manitoba, Canada
| | - Brian Custer
- Vitalant Research Institute, San Francisco, California, USA
- Department of Laboratory Medicine, University of California San Francisco, California, USA
| | - Michael Busch
- Vitalant Research Institute, San Francisco, California, USA
| | | | - Melinda M Dean
- School of Health, University of the Sunshine Coast, Petrie, Queensland, Australia
- Research and Development, Australian Red Cross Lifeblood, Brisbane, Queensland, Australia
| | - Jessika Acutt
- School of Health, University of the Sunshine Coast, Petrie, Queensland, Australia
| | - Elvina Viennet
- Research and Development, Australian Red Cross Lifeblood, Brisbane, Queensland, Australia
| | - Thijs van de Laar
- Department of Donor Medicine Research, Sanquin Research, Amsterdam, The Netherlands
| | - Wai-Chiu Tsoi
- Hong Kong Red Cross Blood Transfusion Service, Hong Kong
| | - Claire Styles
- Pathology & Clinical Governance, Australian Red Cross Lifeblood, Melbourne, Australia
| | - Phil Kiely
- Pathology & Clinical Governance, Australian Red Cross Lifeblood, Melbourne, Australia
| | - Angelo Margaritis
- Manufacturing & Logistics, Australian Red Cross Lifeblood, Melbourne, Australia
| | - So-Yong Kwon
- Korean Red Cross Blood Services, Republic of Korea
| | - Yan Qiu
- Beijing Red Cross Blood Centre, Beijing, China
| | | | | | | | | | - David Juhl
- University Hospital of Schleswig-Holstein, Institute of Transfusion Medicine, Germany
| | | | | | | | | | | | | | | | - Emma Castro
- Centro de Transfusión de la Comunidad Valenciana, Spain
| | | | - Heli Harvala
- Microbiology Services, NHS Blood and Transplant, UK
| | | | | | - Lisa Jarvis
- Scottish National Blood Transfusion Service, UK
| | - Piotr Grabarczyk
- Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Aneta Kopacz
- Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | | | | | - Fiona Young
- Irish Blood Transfusion Service, Dublin, Ireland
| | | | - Lisa Burke
- Irish Blood Transfusion Service, Dublin, Ireland
| | | | | | - Isabel Page
- Centro de Hemoterapia y Hemodonacion de Castilla y Leon, Spain
| | | | - Christoph Niederhauser
- Interregional Blood Transfusion SRC, Switzerland
- Institute for Infectious Diseases, University of Berne, Berne, Switzerland
| | | | - Syria Laperche
- Etablissement Français du Sang, La Plaine Saint Denis, France
| | - Pierre Gallian
- Etablissement Français du Sang, La Plaine Saint Denis, France
| | | | | | | | - Sandra V Gallego
- Fundación Banco Central de Sangre, Argentina
- Virology Institute, School of Medicine, National University of Cordoba, Argentina
| | - Axel Seltsam
- Bavarian Red Cross Blood Donation Service, Wiesentheid, Germany
| | | | - Arwa Z Al-Riyami
- Sultan Qaboos University Hospital, Sultan Qaboos University, Oman
| | | | - Fatma Ba Alawi
- Sultan Qaboos University Hospital, Sultan Qaboos University, Oman
| | - Hem Chandra Pandey
- Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India
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Sedohara A, Takahashi K, Arai K, Arizono K, Tuvshinjargal K, Saito M, Nakahara F, Tsutsumi T, Ikeuchi K, Adachi E, Yotsuyanagi H. Characterization of mutations in hepatitis B virus DNA isolated from Japanese HBsAg-positive blood donors in 2021 and 2022. Arch Virol 2024; 169:103. [PMID: 38632180 PMCID: PMC11023964 DOI: 10.1007/s00705-024-06016-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/04/2024] [Indexed: 04/19/2024]
Abstract
Missense mutations in certain small envelope proteins diminish the efficacy of antibodies. Consequently, tracking the incidence and types of vaccine-escape mutations (VEMs) was crucial both before and after the introduction of universal hepatitis B vaccination in Japan in 2016. In this study, we isolated hepatitis B virus (HBV) DNA from 58 of 169 hepatitis B surface antigen (HBsAg)-positive blood samples from Japanese blood donors and determined the nucleotide sequence encoding the small envelope protein. DNA from six (10%) of the samples had VEMs, but no missense mutations, such as G145R, were detected. Complete HBV genome sequences were obtained from 29 of the 58 samples; the viral genotype was A1 in one (3%), A2 in three (10%), B1 in nine (31%), B2 in five (17%), B4 in one (3%), and C2 in 10 (34%) samples. Tenofovir-resistance mutations were detected in two (7%) samples. In addition, several core promoter mutations, such as 1762A>T and 1764G>A, and a precore nonsense mutation, 1986G>A, which are risk factors for HBV-related chronic liver disease, were detected. These findings provide a baseline for future research and highlight the importance of ongoing monitoring of VEMs and drug resistance mutations in HBV DNA from HBsAg-positive blood donors without HBV antibodies.
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Affiliation(s)
- Ayako Sedohara
- Division of Infectious Diseases, Advanced Clinical Research Center, Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
| | - Kazuaki Takahashi
- Division of Infectious Diseases, Advanced Clinical Research Center, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Keiko Arai
- Division of Infectious Diseases, Advanced Clinical Research Center, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Kotaro Arizono
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan
| | - Khulan Tuvshinjargal
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan
| | - Makoto Saito
- Department of Infectious Disease and Applied Immunology, IMSUT Hospital of The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Fumio Nakahara
- Division of Infectious Diseases, Advanced Clinical Research Center, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Division of Regenerative Medicine, Center for Molecular Medicine, Jichi Medical University, Tochigi, Japan
| | - Takeya Tsutsumi
- Department of Infectious Disease and Applied Immunology, IMSUT Hospital of The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Department of Infectious Diseases, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuhiko Ikeuchi
- Department of Infectious Disease and Applied Immunology, IMSUT Hospital of The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Eisuke Adachi
- Department of Infectious Disease and Applied Immunology, IMSUT Hospital of The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Yotsuyanagi
- Division of Infectious Diseases, Advanced Clinical Research Center, Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
- Department of Infectious Disease and Applied Immunology, IMSUT Hospital of The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
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Damiani AS, Holzmayer V, Galli C, De Nuzzo M, Anderson M, Cloherty G, Di Renzo N. Serological and Molecular Characterization of Occult HBV Infection in Blood Donors from South Italy. Viruses 2023; 16:71. [PMID: 38257771 PMCID: PMC10819115 DOI: 10.3390/v16010071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 01/24/2024] Open
Abstract
Despite good vaccine coverage and careful blood donor selection policies, hepatitis B virus (HBV) is still the most frequent viral infection among blood donors (BDs) in Italy, mostly in the occult form (OBI). We studied the virological features of OBI in BDs from South Italy by serology, molecular testing for HBV-DNA, and sequencing for HBV genotypes and mutations. One hundred and two samples from 95 BDs (22.1% first time, 87.9% regular, median age 57 years) positive for HBV-DNA and negative for HBsAg were retrospectively analyzed. HBV biomarkers were detected in 96.9% (anti-HBc in 44.2%, anti-HBc plus anti-HBs in 49.5%, anti-HBs alone in 3.2%). No risk factor was declared by 45.3% of donors. HBV-DNA levels were very low (median: 7 IU/mL). All samples harbored HBV genotype D and single or multiple mutations in the S gene were found in 28/36 sequences analyzed and in 75% of donors. Mutations were unrelated to gender, donor group or serological patterns. An HBsAg assay with enhanced sensitivity was positive in samples from seven donors (7.4%), two of which negative for HBV-DNA by real-time PCR. OBI still represents a risk for HBV transmission from blood donations; screening by highly sensitive serological and molecular assays is warranted.
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Affiliation(s)
| | - Vera Holzmayer
- R&D, Abbott Diagnostics, Chicago, IL 60064, USA; (V.H.); (M.A.); (G.C.)
| | | | - Mariangela De Nuzzo
- Servizio Immunotrasfusionale, A.O. Vito Fazzi, 73100 Lecce, Italy; (M.D.N.); (N.D.R.)
| | - Mark Anderson
- R&D, Abbott Diagnostics, Chicago, IL 60064, USA; (V.H.); (M.A.); (G.C.)
| | - Gavin Cloherty
- R&D, Abbott Diagnostics, Chicago, IL 60064, USA; (V.H.); (M.A.); (G.C.)
| | - Nicola Di Renzo
- Servizio Immunotrasfusionale, A.O. Vito Fazzi, 73100 Lecce, Italy; (M.D.N.); (N.D.R.)
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