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Dutch M, Cheng A, Kiely P, Seed C. Revised nucleic acid test window periods: Applications and limitations in organ donation practice. Transpl Infect Dis 2024; 26:e14180. [PMID: 37885419 DOI: 10.1111/tid.14180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/10/2023] [Accepted: 10/15/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Nucleic acid test window periods for HIV, HCV, and HBV facilitate estimation of the residual risk of unexpected disease transmission and assist clinicians in determining the timeframe in which a recently acquired infection is at risk of nondetection. OBJECTIVES Firstly, to provide revised estimates of the NAT window periods based on a currently used triplex NAT assay. Secondly, to examine their validity in organ donation and transplantation practice. METHOD Estimates were based on the Procleix Ultrio Elite Assay (Grifols Diagnostic Solutions Inc. California, USA). The manufacturer's X50 and X95 limits of detection (LOD) were utilised. Viral doubling times of 0.85, 0.45, and 2.56 days and conversion factors for IU per ml to copies per mL of 0.6, 3.4, and 5 were assumed for HIV, HCV, and HBV respectively. Window periods were derived from the X50 and X95 LODs, based on a range of potential inoculum volumes. RESULTS Calculated X50 window periods were 5.1 (4.5-5.8), 2.7 (2.4-2.9), and 16.6 (14.2-19.1) days for HIV, HCV, and HBV respectively. Calculated X50 window periods, based on whole body plasma volume, were 11.8 (10.3-13.3), 6.2 (5.6-6.8) and 36.7 (31.3-42.1) days respectively. CONCLUSION X50 NAT window periods were significantly shorter for HBV and HCV and sit at the lower range of previously published estimates for HIV . Current modeling assumptions may not account for all unexpected transmission events and may no longer be suitable for application to organ donation and transplantation.
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Affiliation(s)
- Martin Dutch
- Emergency Department, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Critical Care, University of Melbourne, Melbourne, Victoria, Australia
| | - Anthea Cheng
- Pathology and Clinical Governance, Australian Red Cross Lifeblood, West Melbourne, Victoria, Australia
| | - Philip Kiely
- Pathology and Clinical Governance, Australian Red Cross Lifeblood, West Melbourne, Victoria, Australia
- Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Prahran, Victoria, Australia
| | - Clive Seed
- Pathology and Clinical Governance, Australian Red Cross Lifeblood, West Melbourne, Victoria, Australia
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Ye X, Liu L, Chen L, Nie X, Huang L, Ye D, Zeng J, Li T, Li B, Xu M, Chen L. High-Frequency Notable HBV Mutations Identified in Blood Donors With Occult Hepatitis B Infection From Heyuan City of Southern China. Front Immunol 2022; 13:754383. [PMID: 35634299 PMCID: PMC9136029 DOI: 10.3389/fimmu.2022.754383] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 04/15/2022] [Indexed: 11/14/2022] Open
Abstract
Background All Chinese blood centers have implemented mini pool (MP) HBV nucleic acid testing (NAT) together with HBsAg ELISA in routine donor screening since 2015. The prevalence of occult hepatitis B virus infection (OBI) in donors from different regions varies, and the molecular characterization of the HBV DNA and clinical outcomes of these OBIs remain largely unexplored. Methods Blood donations from Heyuan city in Southern China were screened by HBsAg ELISA and HBV MP8 NAT. Donations with HBsAg-/HBV DNA+ were collected for this study. Molecular characterizations of HBV DNAs were further analyzed by various DNA amplification assays including quantitative PCR (qPCR) and nested PCR, amplifying the basic core and pre-core promoter regions (BCP/PC). The HBsAg (S) region from HBV DNA was isolated by high-volume nucleic acid extraction. Notable mutations were identified by comparison to the HBV reference sequences. The clinical outcomes of the donors with OBIs were further followed for nearly 3 years. Results Seventy OBIs from 44,592 donations (0.15%) that we identified and reported previously were enrolled for this current study. HBV sequences were obtained from 44/70 OBIs, and genotyping analysis showed that 42/44 (95.2%) OBIs were genotype B, and 2/44 (4.8%) were genotype C. Interestingly, mutation analysis revealed that various mutations including M133L/T, F134L, P142L, V168A, R169H, S174N, L175S, and V177A of HBV DNA affecting HBsAg detection were observed in genotype B OBIs. Two notable mutations, T47K and L53S, were identified in genotype C OBIs. Follow-up studies showed that 3/31 (9.7%) OBIs converted to HBsAg+ as chronic infections while 1/31 (3.2%) HBV DNA was undetectable (classified as recovery) and 27/31 (87.1%) remained as OBIs. Conclusion Various notable mutations affecting HBsAg detection were observed in blood donors with OBIs in Heyuan city of Southern China. Follow-up studies showed that most OBIs remained as OBIs with fluctuating or low viral loads. Higher sensitive HBV ID NAT is recommended for donor screening to further reduce the transmission risk of OBIs.
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Affiliation(s)
- Xianlin Ye
- Department of Laboratory, Shenzhen Blood Center, Shenzhen, China
| | - Lihua Liu
- Department of Laboratory, Heyuan Blood Center, Heyuan, China
| | - Lina Chen
- Department of Laboratory, Heyuan Blood Center, Heyuan, China
| | - Xianghui Nie
- Department of Laboratory, Heyuan Blood Center, Heyuan, China
| | - Lu Huang
- Department of Laboratory, Heyuan Blood Center, Heyuan, China
| | - Denghuang Ye
- Department of Laboratory, Heyuan Blood Center, Heyuan, China
| | - Jinfeng Zeng
- Department of Laboratory, Shenzhen Blood Center, Shenzhen, China
| | - Tong Li
- Department of Laboratory, Shenzhen Blood Center, Shenzhen, China
| | - Bin Li
- The Joint Laboratory on Transfusion-Transmitted Diseases (TTDs) between Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Nanning Blood Center, Nanning Blood Center, Nanning, China
- *Correspondence: Bin Li, ; Min Xu, ; Limin Chen,
| | - Min Xu
- Provincial Key Laboratory for Transfusion-Transmitted Diseases, Institute of Blood Transfusion, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Chengdu, China
- *Correspondence: Bin Li, ; Min Xu, ; Limin Chen,
| | - Limin Chen
- The Joint Laboratory on Transfusion-Transmitted Diseases (TTDs) between Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Nanning Blood Center, Nanning Blood Center, Nanning, China
- Provincial Key Laboratory for Transfusion-Transmitted Diseases, Institute of Blood Transfusion, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Chengdu, China
- *Correspondence: Bin Li, ; Min Xu, ; Limin Chen,
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Lelie N, Busch M, Kleinman S. Residual risk of transfusion-transmitted hepatitis B virus (TT-HBV) infection by NAT-screened blood components: A review of observed versus modeled infectivity from donors with window period and occult HBV infections. Transfusion 2021; 61:3190-3201. [PMID: 34590320 DOI: 10.1111/trf.16675] [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: 12/02/2020] [Revised: 08/26/2021] [Accepted: 09/02/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND The residual transfusion-transmitted hepatitis B virus (TT-HBV) risk with different testing strategies depends on the sensitivity of screening assays, the prevalence of hepatitis B surface antigen (HBsAg) compared to HBV-DNA in window period (WP) and occult HBV infections (OBIs), and infectivity of blood in these infection stages. We compared modeled WP and OBI transmission risk in a multiregional individual donation nucleic acid amplification technology (ID-NAT) screening study with observed TT-HBV infection rates in several lookback studies. STUDY DESIGN AND METHODS The WP and OBI risk was estimated from ID-NAT screening data in six geographic regions. The 50% infectious dose (ID50 ), a key factor in the applied risk models, was assumed to be 100-fold higher in OBI than in WP blood. The relative proportion of WP and OBI TT-risk was estimated for different screening scenarios and expressed as a percentage of the ID-NAT yield rate to allow for comparison with observed TT-rates in lookback studies. RESULTS Despite sevenfold to eightfold higher HBV ID-NAT yield rates in OBI than WP in South-East Asia and Europe, our models predicted that 40 (26-55)% of total residual TT-HBV risk was due to OBI, comparable to 37% observed in a Japanese hemovigilance study. Modeled TT-OBI risk was approximately 10-fold higher than observed rates of 2%-8% in five lookback studies but comparable to one other study (36%). CONCLUSION Although the observed TT-OBI rate was generally lower than the modeled risk, the relative risk of WP versus OBI transmission was not incompatible with the observational infectivity data. This supports the validity of our assumptions in the infectivity-based models for estimating worst-case residual risk with different testing scenarios.
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Affiliation(s)
- Nico Lelie
- Lelie Research, Alkmaar, The Netherlands
| | - Michael Busch
- Vitalant Research Institute, San Francisco, California, USA
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Harvala H, Reynolds C, Gibney Z, Derrick J, Ijaz S, Davison KL, Brailsford S. Hepatitis B infections among blood donors in England between 2009 and 2018: Is an occult hepatitis B infection a risk for blood safety? Transfusion 2021; 61:2402-2413. [PMID: 34114670 DOI: 10.1111/trf.16543] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 05/16/2021] [Accepted: 05/17/2021] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Hepatitis B virus (HBV) is one of the most frequent infections identified in blood donors in England and represents an ongoing blood safety risk. We have analyzed markers of HBV infections in blood donors in England between 2009 and 2018 and used these to estimate the likelihood of non-detection of occult HBV infection (OBI). METHODS We collected epidemiological, virological, and genotyping information on HBV cases identified in England, 2009-2018. The estimated risk of non-detection and likely transmission of OBI were compared to lookback and transfusion-transmitted infections surveillance data. RESULTS Six-hundered and fifty-five HBV-infected blood donors were identified in England during the 10-year period; 598 chronic, 32 acute, and 25 occult HBV infections. However, most donors with chronic and occult infections were born in Eastern Europe, Africa, or Asia (451/544, 83% and 14/24, 58%); acute infections were largely seen in UK-born donors (19/28, 68%). Genotyping of 266 HBV-positive samples revealed five genotypes (A-E), reflecting ethnicity and country of birth. Most OBIs were identified in repeat donors (19/25); lookback data identified a transmission rate of 8.3%. It is estimated that at least 13 potentially infectious donations from donors with OBI remain undetected annually, equating to an overall residual transmission risk of 3.1 per million donations using our current screening strategy of HBsAg screening with HBV nucleic acid testing (NAT) in pools of 24. CONCLUSIONS OBI accounted for the majority of the HBV residual risk in England. Further cost-benefit analysis is required to estimate if our current HBV screening strategy should be changed.
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Affiliation(s)
- Heli Harvala
- Microbiology Services, NHS Blood and Transplant, London, UK.,Infection and Immunity, University College of London, London, UK
| | - Claire Reynolds
- NHS Blood and Transplant/Public Health England Epidemiology Unit, NHS Blood and Transplant, London, UK
| | - Zoë Gibney
- NHS Blood and Transplant/Public Health England Epidemiology Unit, Public Health England, London, UK
| | - Jade Derrick
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, London, UK
| | - Samreen Ijaz
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, London, UK
| | - Katy L Davison
- NHS Blood and Transplant/Public Health England Epidemiology Unit, Public Health England, London, UK
| | - Su Brailsford
- Microbiology Services, NHS Blood and Transplant, London, UK.,NHS Blood and Transplant/Public Health England Epidemiology Unit, NHS Blood and Transplant, London, UK
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van de Laar TJ, Hogema BM, Molenaar-de Backer MW, Marijt-van der Kreek T, Zaaijer HL. Blood donor screening in the Netherlands: Universal anti-HBc screening in combination with HBV nucleic acid amplification testing may allow discontinuation of hepatitis B virus antigen testing. Transfusion 2021; 61:2116-2124. [PMID: 33899233 DOI: 10.1111/trf.16420] [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: 10/25/2020] [Revised: 04/01/2021] [Accepted: 04/01/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND In the Netherlands, blood donor screening for hepatitis B virus (HBV) consists of HBsAg screening since the 1970s, HBV DNA minipool testing (MP-NAT) since 2008, and anti-HBc screening since 2011. Anti-HBc reactivity causes deferral only if anti-HBs titers are <200 IU/mL, or when anti-HBc was acquired during follow-up. STUDY DESIGN AND METHODS Over 5.5 million donations from 582,459 Dutch donors were screened for HBV DNA, HBsAg, anti-HBc, and, if anti-HBc positive, also for anti-HBs. The added value, expressed as the yield of (potentially) infectious and/or recent HBV infections versus unnecessary donor loss, was evaluated for each of the three HBV screening tests. RESULTS HBV donor screening identified 89 HBV-infected donors with at least two reactive HBV markers (MP-NAT, HBsAg and/or anti-HBc). Single HBV-marker yield was: 5 MP-NAT-only, 0 HBsAg-only, and 20 anti-HBc-only donors. In addition, anti-HBc screening yielded 1,067 potentially infectious donors at risk for occult HBV infection (OBI). In total, 4,126 (0.71%) donors were anti-HBc-reactive at first-time screening, and 1,098 (0.19%) seroconverted during follow-up. Anti-HBc-related donor loss was limited to 2,627 (0.45%) donors using anti-HBs titers and two-strike programs. Donor loss due to MP-NAT and HBsAg screening was extremely low: 0 and 128 donors, respectively. CONCLUSION HBV donor screening could be limited to MP-NAT and anti-HBc screening. MP-NAT and anti-HBc improved blood safety by intercepting infectious donations from donors with recent infection or OBI, while HBsAg did not. Unnecessary donor loss related to anti-HBc screening is substantial but does not endanger the continuity of the blood supply.
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Affiliation(s)
- Thijs J van de Laar
- Department of Donor Medicine Research, Laboratory of Blood-borne Infections, Sanquin Research, Amsterdam, The Netherlands.,Department of Virology and MAT Services, Sanquin Diagnostic Services, Amsterdam, The Netherlands.,Laboratory of Medical Microbiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Boris M Hogema
- Department of Donor Medicine Research, Laboratory of Blood-borne Infections, Sanquin Research, Amsterdam, The Netherlands.,Department of Virology and MAT Services, Sanquin Diagnostic Services, Amsterdam, The Netherlands
| | | | | | - Hans L Zaaijer
- Department of Donor Medicine Research, Laboratory of Blood-borne Infections, Sanquin Research, Amsterdam, The Netherlands.,Department of Clinical Virology, Amsterdam University Medical Centre, Amsterdam, The Netherlands
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Grubyte S, Urboniene J, Nedzinskiene L, Jelinskaite A, Zagminas K, Ambrozaitis A, Jancoriene L. Prevalence, incidence and residual risk of transfusion transmitted viruses (HBV, HCV and HIV infections) in Lithuanian blood donors from 2004 to 2018: The incidence/window-period model study. PLoS One 2021; 16:e0246704. [PMID: 33606700 PMCID: PMC7894937 DOI: 10.1371/journal.pone.0246704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 01/25/2021] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION Estimation of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) transfusion risk in blood donors is essential for monitoring the safety of the blood supply and the impact of new screening tests. Due to improvements in donor selection and continuing progress in screening assays, residual risk of virus transmission has significantly decreased over the past years. It is not practical and sometimes even not possible to measure residual risk in blood donors directly and mathematical models are used. The aim of this study was to calculate the prevalence, incidence rates of HBV, HCV and HIV infections and analyse evolution of their transmission residual risk from 2004 to 2018 at the National Blood Center of Lithuania. MATERIALS AND METHODS Data from the archives of the National Blood Center of Lithuania from 2004 to 2018 was retrospectively analysed. The residual risk was calculated for each virus and year by applying the incidence/window-period model suggested by World Health Organization. For the analysis of the residual risk yearly trends a linear regression was used. RESULTS A total of 754,755 blood donors and 1,245,568 donations were included in the analysis and represented a 2.06 donations per donor over 15 years. Average residual risk for HBV, HCV and HIV respectively was 570.04, 807.14 and 35.72 per 1,00,000 donations. During the study period, there was statistically significant downward trend in the residual risk for every analysed virus. DISCUSSION Residual risk of virus transmission has been steadily decreasing over past 15 years in Lithuanian donors, but the current risk remains quite high. It is difficult to establish how much the risk is affected by statistical assumptions or virus prevalence in general population. However, results of this study indicate the need of the population screening program of transfusion transmitted viruses.
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Affiliation(s)
- Samanta Grubyte
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Jurgita Urboniene
- Center of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Laura Nedzinskiene
- Department of Anatomy, Histology and Anthropology, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Auguste Jelinskaite
- Center of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Kestutis Zagminas
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Arvydas Ambrozaitis
- Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Ligita Jancoriene
- Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Prevalence, incidence and residual risk of transfusion-transmitted hepatitis B virus infection in Italy from 2009 to 2018. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2019; 17:409-417. [PMID: 31846606 DOI: 10.2450/2019.0245-19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 11/25/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND In Italy, the use of nucleic acid testing for hepatitis B virus (HBV) in donor screening has allowed the detection of infections in the window phase, as well as the presence of occult infections which could potentially be transmitted. The aim of this study was to analyse the trends of epidemiological data focused on HBV infection in blood donors and to estimate the residual risk of transmitting HBV from both the window phase and occult infection over a 10-year period in Italy. MATERIALS AND METHODS Data were obtained from the Italian Haemovigilance System which includes the results of screening tests for transfusion transmissible infections. During the period of this survey (2009-2018), the molecular methods used for HBV screening were transcription-mediated amplification and polymerase chain reaction tests. Prevalence and incidence were calculated. The residual risk was estimated by applying the incidence-window period model for acute cases and a more recently reported model for estimating the risk due to occult infections. RESULTS A total of 17,424,535 blood donors and 30,842,794 donations were tested for HBV. Altogether, 6,250 donors tested positive for HBV markers: 4,782 (175.6×105) were first time donors and 1,468 (10.0×105) were repeat donors. The prevalence of HBV markers in first time donors was 275.9×105 in 2009, declining to 143.6×105 in 2018. The incidence of new infections was 3.37×105 in 2009 and 2.17×105 in 2018. The overall residual risk for HBV amounted to 1 in 2,566,854 donations calculated as the sum of risks of both acute infections in the window period (1 in 5,835,306 donations) and occult infections (1 in 4,582,270 blood units). DISCUSSION In Italy, the residual risk of transfusing a blood unit infected with HBV, both from window phase and occult infections, is currently very low, amounting to levels that can be considered tolerable.
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López-Menchero C, Alvarez M, Fernández P, Guzmán M, Ortiz-de-Salazar MI, Arbona C. Evolution of the residual risk of HBV, HCV and HIV transmission through blood transfusion in the Region of Valencia, Spain, during a 15-year period (2003-2017). BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2019; 17:418-427. [PMID: 31403928 PMCID: PMC6917534 DOI: 10.2450/2019.0058-19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 07/09/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND Towards the end of the 20th century, transfusion-transmitted viral infections (TTVI) represented a huge problem for public health. From the beginning of the screening of blood donations, this risk has decreased to the point that it is no longer possible to measure it directly and it is necessary to use mathematical models. Using one of these models, the aim of this study was to analyse the evolution of the residual risk of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) transmission through blood transfusion from 2003 to 2017 in the Region of Valencia, Spain. MATERIALS AND METHODS Using data from the Blood Transfusion Centre of the Valencian Community, the incidence rate in donors and the residual risk were calculated for each agent and year by applying the most updated version of the incidence/window period model. For the set of the three viruses, these magnitudes were calculated as the algebraic sum of the specifics ones for each of them. The evolution of both magnitudes was analysed by the Mann-Kendall trend test and the Sen estimation of trend slope. RESULTS The residual risks obtained vary depending on the agent and the year. Considering the three viruses jointly, they range from 1 per 360,380 to 1 per 44,715 donations. During the study period, there was a statistically significant downward trend in the incidence rate of HBV (p<0.05, trend slope -0.88), the residual risk of HBV (p<0.0005, slope -0.98), and the joint residual risk for the three viruses (p<0.0001, slope -0.99). DISCUSSION The current risk of TTVI is very low in the Region of Valencia. In the last 15 years, there has been a reduction in the donor incidence rate and in the residual risk for the case of HBV; such a reduction cannot be confirmed for HCV and HIV. Consideration of the three viruses jointly confirms a reduction in the residual risk; we are unable to establish whether the evolution of the joint incidence rate has contributed to this reduction or whether it is due only to the shortening of window periods.
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Affiliation(s)
| | - Manuel Alvarez
- Blood Transfusion Centre of the Valencian Community, Valencia, Spain
| | - Pascual Fernández
- Department of Clinical Medicine, School of Medicine, Miguel Hernández University, Sant Joan d'Alacant, Spain
| | - María Guzmán
- Blood Transfusion Centre of the Valencian Community, Valencia, Spain
| | | | - Cristina Arbona
- Blood Transfusion Centre of the Valencian Community, Valencia, Spain
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Seed CR, Allain J, Lozano M, Laperche S, Gallian P, Gross S, Kwon S, Oh E, Kim J, Chua SS, Lam S, Ang AL, Tsoi W, Hewitt PE, Davison KL, Tettmar K, O'Flaherty N, Boland F, Williams P, Pomeroy L, Wendel S, Fachini R, Scuracchio P, Carminato P, Fearon M, O'Brien SF, Delage G, Kiely P, Hoad V, Matsubayashi K, Satake M, Taira R, Stramer SL, Sauleda S, Bes M, Piron M, El Ekiaby M, Vermeulen M, Levičnik Stezinar S, Nograšek P, Jarvis LM, Petrik J, Charlewood R, Flanagan P, Grabarczyk P, Kopacz A, Łętowska M, Seifried E, Schmidt M. International Forum on Occult hepatitis B infection and transfusion safety. Vox Sang 2019; 114:e1-e35. [DOI: 10.1111/vox.12743] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
| | | | | | - Syria Laperche
- Institut National de la Transfusion Sanguine Département des agents transmissibles par le sang Centre National de Référence Risques Infectieux Transfusionnels 6 rue Alexandre Cabanel Paris 75015 France
| | - Pierre Gallian
- Etablissement Français du Sang 20 Avenue du Stade de France La Plaine Saint‐Denis 93218 France
| | - Sylvie Gross
- Etablissement Français du Sang 20 Avenue du Stade de France La Plaine Saint‐Denis 93218 France
| | - So‐Yong Kwon
- Jungbu Blood Laboratory Center Korean Red Cross 22 Songchonam‐ro, Daedeok‐gu Daejeon Korea
| | - E.Y. Oh
- Jungbu Blood Laboratory Center Korean Red Cross 22 Songchonam‐ro, Daedeok‐gu Daejeon Korea
| | - J.N. Kim
- Division of Human Blood Safety Surveillance Korea Centers for Disease Control and Prevention Osong Korea
| | - Sze Sze Chua
- Health Sciences Authority Blood Services Group 11 Outram Road Singapore 169078 Singapore
| | - Sally Lam
- Health Sciences Authority Blood Services Group 11 Outram Road Singapore 169078 Singapore
| | - Ai Leen Ang
- Health Sciences Authority Blood Services Group 11 Outram Road Singapore 169078 Singapore
| | - Wai‐Chiu Tsoi
- Hong Kong Red Cross Blood Transfusion Service 15 King's Park Rise Kowloon Hong Kong China
| | | | - Katy L. Davison
- NHS Blood and Transplant Public Health England Epidemiology Unit Colindale Avenue Colindale UK
| | - Kate Tettmar
- NHS Blood and Transplant Colindale Centre Charcot Road Colindale UK
| | - Niamh O'Flaherty
- Irish Blood Transfusion Service National Blood Centre St. James's Gate Dublin 8 Ireland
| | - Fiona Boland
- Irish Blood Transfusion Service National Blood Centre St. James's Gate Dublin 8 Ireland
| | - Padraig Williams
- Irish Blood Transfusion Service National Blood Centre St. James's Gate Dublin 8 Ireland
| | - Louise Pomeroy
- Irish Blood Transfusion Service National Blood Centre St. James's Gate Dublin 8 Ireland
| | - Silvano Wendel
- Hospital Sirio Libanês Rua Adma Jafet 91 São Paulo 01308‐050 Brasil
| | - Roberta Fachini
- Hospital Sirio Libanês Rua Adma Jafet 91 São Paulo 01308‐050 Brasil
| | | | | | | | | | - Gilles Delage
- Héma Québec 4045 boul. Cote‐Vertu ville Saint Laurent QC Canada
| | - Philip Kiely
- Australian Red Cross Blood Service 100‐154 Batman Street West Melbourne VIC 3003 Australia
| | - Veronica Hoad
- Australian Red Cross Blood Service 290 Wellington Street Perth WA 6000 Australia
| | - Keiji Matsubayashi
- Central Blood Institute Blood Service Headquarters Japanese Red Cross Society 2‐1‐67 Tatsumi, Koto‐ku Tokyo Japan
| | - Masahiro Satake
- Central Blood Institute Blood Service Headquarters Japanese Red Cross Society 2‐1‐67 Tatsumi, Koto‐ku Tokyo Japan
| | - Rikizo Taira
- Technical Department Blood Service Headquarters Japanese Red Cross Society 1‐2‐1 Shibakoen, Minato‐ku Tokyo Japan
| | | | - Silvia Sauleda
- Transfusion Safety Laboratory Banc de Sang i Teixits Doctor Frederic Duran i Jorda Building, Passeig Taulat, 116 08005 Barcelona Spain
| | - Marta Bes
- Transfusion Safety Laboratory Banc de Sang i Teixits Doctor Frederic Duran i Jorda Building, Passeig Taulat, 116 08005 Barcelona Spain
| | - Maria Piron
- Transfusion Safety Laboratory Banc de Sang i Teixits Doctor Frederic Duran i Jorda Building, Passeig Taulat, 116 08005 Barcelona Spain
| | - Magdy El Ekiaby
- Shabrawishi Hospital Blood Transfusion Centre Finni Square Dokki, Giza Egypt
| | - Marion Vermeulen
- The South African National Blood Service 1 Constantia Boulevard, ConstantiaKloof Roodepoort, Gauteng South Africa
| | | | - Polona Nograšek
- Blood Transfusion Centre of Slovenia Šlajmerjeva 6 SI‐1000 Ljubljana Slovenia
| | - Lisa M. Jarvis
- Scottish National Blood Transfusion Service The Jack Copland Centre 52 Research Avenue North Edinburgh EH14 4BE UK
| | - Juraj Petrik
- Scottish National Blood Transfusion Service The Jack Copland Centre 52 Research Avenue North Edinburgh EH14 4BE UK
| | - Richard Charlewood
- New Zealand Blood Service 71 Great South Road Epsom, Auckland New Zealand
| | - Peter Flanagan
- New Zealand Blood Service 71 Great South Road Epsom, Auckland New Zealand
| | - Piotr Grabarczyk
- Department of Virology Institute of Hematology and Transfusion Medicine Gandhi Str. 14th 02 776 Warsaw Poland
| | - Aneta Kopacz
- Department of Virology Institute of Hematology and Transfusion Medicine Gandhi Str. 14th 02 776 Warsaw Poland
| | - Magdalena Łętowska
- Department of Transfusion Institute of Hematology and Transfusion Medicine Gandhi Str. 14th 02 776 Warsaw Poland
| | - Erhard Seifried
- German Red Cross Institute for Transfusion medicine and Immunohematology German Red Cross Baden‐Wuerrtemberg – Hesse Goethe University Frankfurt Sandhof Street 1 60528 Frankfurt
| | - Michael Schmidt
- German Red Cross Institute for Transfusion medicine and Immunohematology German Red Cross Baden‐Wuerrtemberg – Hesse Goethe University Frankfurt Sandhof Street 1 60528 Frankfurt
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10
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Seed CR, Allain JP, Lozano M, Laperche S, Gallian P, Gross S, Kwon SY, Oh EY, Kim JN, Chua SS, Lam S, Ang AL, Tsoi WC, Hewitt PE, Davison K, Tettmar K, O'Flaherty N, Boland F, Williams P, Pomeroy L, Wendel S, Fachini R, Scuracchio PSP, Carminato P, Fearon M, O'Brien SF, Delages G, Kiely P, Hoad VC, Matsubayashi K, Satake M, Taira R, Stramer SL, Sauleda S, Bes M, Piron M, Ekiaby ME, Vermeulen M, Stezinar SL, Nograšek P, Jarvis LM, Petrik J, Charlewood R, Flanagan P, Grabarczyk P, Kopacz A, Łętowska M, Schmidt M, Seifried E. International forum on Occult hepatitis B infection and transfusion safety. Vox Sang 2019; 114:397-406. [PMID: 30818422 DOI: 10.1111/vox.12744] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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11
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Candotti D, Laperche S. Hepatitis B Virus Blood Screening: Need for Reappraisal of Blood Safety Measures? Front Med (Lausanne) 2018. [PMID: 29515997 PMCID: PMC5826332 DOI: 10.3389/fmed.2018.00029] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Over the past decades, the risk of HBV transfusion–transmission has been steadily reduced through the recruitment of volunteer donors, the selection of donors based on risk-behavior evaluation, the development of increasingly more sensitive hepatitis B antigen (HBsAg) assays, the use of hepatitis B core antibody (anti-HBc) screening in some low-endemic countries, and the recent implementation of HBV nucleic acid testing (NAT). Despite this accumulation of blood safety measures, the desirable zero risk goal has yet to be achieved. The residual risk of HBV transfusion–transmission appears associated with the preseroconversion window period and occult HBV infection characterized by the absence of detectable HBsAg and extremely low levels of HBV DNA. Infected donations tested false-negative with serology and/or NAT still persist and derived blood components were shown to transmit the virus, although rarely. Questions regarding the apparent redundancy of some safety measures prompted debates on how to reduce the cost of HBV blood screening. In particular, accumulating data strongly suggests that HBsAg testing may add little, if any HBV risk reduction value when HBV NAT and anti-HBc screening also apply. Absence or minimal acceptable infectious risk needs to be assessed before considering discontinuing HBsAg. Nevertheless, HBsAg remains essential in high-endemic settings where anti-HBc testing cannot be implemented without compromising blood availability. HBV screening strategy should be decided according to local epidemiology, estimate of the infectious risk, and resources.
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Affiliation(s)
- Daniel Candotti
- Department of Blood-Transmitted Pathogens, National Transfusion Infectious Risk Reference Laboratory, National Institute of Blood Transfusion, Paris, France
| | - Syria Laperche
- Department of Blood-Transmitted Pathogens, National Transfusion Infectious Risk Reference Laboratory, National Institute of Blood Transfusion, Paris, France
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12
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Zhong Y, Liu DL, Ahmed MMM, Li PH, Zhou XL, Xie QD, Xu XQ, Han TT, Hou ZW, Zhong CY, Huang JH, Zeng F, Huang TH. Host genes regulate transcription of sperm-introduced hepatitis B virus genes in embryo. Reprod Toxicol 2017; 73:158-166. [PMID: 28822827 PMCID: PMC7127588 DOI: 10.1016/j.reprotox.2017.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 08/07/2017] [Accepted: 08/10/2017] [Indexed: 02/05/2023]
Abstract
Hepatitis B virus (HBV) can invade the male germline, and sperm-introduced HBV genes could be transcribed in embryo. This study was to explore whether viral gene transcription is regulated by host genes. Embryos were produced by in vitro fertilization of hamster oocytes with human sperm containing the HBV genome. Total RNA extracted from test and control embryos were subjected to SMART-PCR, SSH, microarray hybridization, sequencing and BLAST analysis. Twenty-nine sequences showing significant identity to five human gene families were identified, with CSH2, EIF4G2, PCBD2, PSG4 and TTN selected to represent target genes. Using qRT-PCR, when CSH2 and PCBD2 (or EIF4G2, PSG4 and TTN) were silenced by RNAi, transcriptional levels of HBV s and x genes decreased (or increased). This is the first report that host genes participate in regulation of sperm-introduced HBV gene transcription in embryo, which is critical to prevent negative impact of HBV infection on early embryonic development.
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Affiliation(s)
- Ying Zhong
- Jinxin Research Institute for Reproductive Medicine and Genetics, Chengdu Jinjiang Hospital for Maternal and Child Health Care, 66 Jinxiu Road, Chengdu 610066, China.
| | - Dong-Ling Liu
- Research Center for Reproductive Medicine, Shantou University Medical College, 22 Xinling Road, Shantou 515041, China.
| | - Mohamed Morsi M Ahmed
- Research Center for Reproductive Medicine, Shantou University Medical College, 22 Xinling Road, Shantou 515041, China.
| | - Peng-Hao Li
- Jinxin Research Institute for Reproductive Medicine and Genetics, Chengdu Jinjiang Hospital for Maternal and Child Health Care, 66 Jinxiu Road, Chengdu 610066, China.
| | - Xiao-Ling Zhou
- Research Center for Reproductive Medicine, Shantou University Medical College, 22 Xinling Road, Shantou 515041, China.
| | - Qing-Dong Xie
- Research Center for Reproductive Medicine, Shantou University Medical College, 22 Xinling Road, Shantou 515041, China.
| | - Xiao-Qing Xu
- Research Center for Reproductive Medicine, Shantou University Medical College, 22 Xinling Road, Shantou 515041, China.
| | - Ting-Ting Han
- Jinxin Research Institute for Reproductive Medicine and Genetics, Chengdu Jinjiang Hospital for Maternal and Child Health Care, 66 Jinxiu Road, Chengdu 610066, China.
| | - Zhi-Wei Hou
- Research Center for Reproductive Medicine, Shantou University Medical College, 22 Xinling Road, Shantou 515041, China.
| | - Chen-Yao Zhong
- Faculty of Science and Engineering, Paul Sabatier University-Toulouse III, 118 Route de Narbonne, Toulouse 31062, France.
| | - Ji-Hua Huang
- Jinxin Research Institute for Reproductive Medicine and Genetics, Chengdu Jinjiang Hospital for Maternal and Child Health Care, 66 Jinxiu Road, Chengdu 610066, China.
| | - Fei Zeng
- The First Affiliated Hospital, Shantou University Medical College, 57 Changping Road, Shantou 515041, China.
| | - Tian-Hua Huang
- Jinxin Research Institute for Reproductive Medicine and Genetics, Chengdu Jinjiang Hospital for Maternal and Child Health Care, 66 Jinxiu Road, Chengdu 610066, China; Research Center for Reproductive Medicine, Shantou University Medical College, 22 Xinling Road, Shantou 515041, China.
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13
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Seed CR. Value of retaining HBsAg donor screening where HBV NAT and anti-HBc donor screening apply. ACTA ACUST UNITED AC 2017. [DOI: 10.1111/voxs.12368] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- C. R. Seed
- Australian Red Cross Blood Service; Perth Australia
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14
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Weusten J, van Drimmelen H, Vermeulen M, Lelie N. A mathematical model for estimating residual transmission risk of occult hepatitis B virus infection with different blood safety scenarios. Transfusion 2017; 57:841-849. [DOI: 10.1111/trf.14050] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 12/06/2016] [Accepted: 12/18/2016] [Indexed: 12/15/2022]
Affiliation(s)
- Jos Weusten
- Philips Handheld Diagnostics; Eindhoven the Netherlands
| | | | | | - Nico Lelie
- Biologicals Quality Control; Rijswijk the Netherlands
- Lelie Research; Paris France
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