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Ye X, Li T, Yu B, Zeng J, Shi Y, Xie H, Branch DR, Loriamini M, Li B, Chen L. The high prevalence of occult hepatitis B infections among the partners of chronically infected HBV blood donors emphasizes the potential residual risk to blood safety. J Med Virol 2023; 95:e29006. [PMID: 37548473 DOI: 10.1002/jmv.29006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/13/2023] [Accepted: 07/19/2023] [Indexed: 08/08/2023]
Abstract
A small percentage of couples who regularly donated blood in China tested positive for HBsAg. Although it is well known that blood donors can acquire hepatitis B virus (HBV) infection from a chronically infected sexual partner, the prevalence of occult hepatitis B infections (OBIs) among blood donations from partners of HBV-infected chronically infected spouses and the risk to blood safety remain poorly understood. Among 212 763 blood donors, 54 pairs of couples (108 donations) were enrolled because one partner tested positive for HBsAg. Several molecular and serological examinations were conducted. The origin of HBV transmission between sexual partners was investigated further. Also evaluated was the potential risk of HBV infection with OBIs. We identified 10 (10/54, 18.6%) sexual partners of chronically infected HBV donors who were positive for HBV DNA, including five samples (9.3%) with OBIs, of which 3 (3/54, 5.6%, 1 in 70 921 donations) passed the routine blood screening tests. Seven of the 10 HBV-DNA-positive couples contracted the virus possibly through sexual or close contact. Among infected couples, immune escape mutations were observed. A high prevalence of OBIs was found among the partners of chronically infected HBV blood donors, posing a potential threat to blood safety.
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Affiliation(s)
- Xianlin Ye
- Department of Laboratory, Shenzhen Blood Center, Shenzhen, Guangdong, China
| | - Tong Li
- Department of Laboratory, Shenzhen Blood Center, Shenzhen, Guangdong, China
| | - Binghuan Yu
- Department of Laboratory, Shenzhen Blood Center, Shenzhen, Guangdong, China
| | - Jinfeng Zeng
- Department of Laboratory, Shenzhen Blood Center, Shenzhen, Guangdong, China
| | - Yaoqiang Shi
- Provincial Key Laboratory for Transfusion-transmitted Infectious Diseases, Institute of Blood Transfusion (IBT), Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Chengdu, Sichuan, China
| | - He Xie
- Provincial Key Laboratory for Transfusion-transmitted Infectious Diseases, Institute of Blood Transfusion (IBT), Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Chengdu, Sichuan, China
- The Hospital of Xidian Group, Xi'an, China
| | - Donald R Branch
- Departments of Medicine and Laboratory Medicine and Pathobiology, Centre for Innovation, Canadian Blood Services, Hamilton, Ontario, Canada
| | - Melika Loriamini
- Departments of Medicine and Laboratory Medicine and Pathobiology, Centre for Innovation, Canadian Blood Services, Hamilton, Ontario, Canada
| | - Bin Li
- The Joint-laboratory of Transfusion-transmitted Diseases (TTDs) between IBT, CAMS, and Nanning Blood Center, Nanning Blood Center, Nanning, China
| | - Limin Chen
- Provincial Key Laboratory for Transfusion-transmitted Infectious Diseases, Institute of Blood Transfusion (IBT), Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Chengdu, Sichuan, China
- The Hospital of Xidian Group, Xi'an, China
- The Joint-laboratory of Transfusion-transmitted Diseases (TTDs) between IBT, CAMS, and Nanning Blood Center, Nanning Blood Center, Nanning, China
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De Brier N, Koc ÖM, De Buck E, Muylaert A, Nevens F, Vanbrabant M, Vandeloo J, Van Remoortel H, Robaeys G, Compernolle V. Hepatitis B virus prevalence in first-time blood donors in Flanders, Belgium: Impact of universal vaccination and migration. Transfusion 2021; 61:2125-2136. [PMID: 33955570 DOI: 10.1111/trf.16431] [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: 10/08/2020] [Revised: 03/24/2021] [Accepted: 03/30/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Transfusion-transmissible infections such as hepatitis B virus (HBV) remain a major concern for the safety of blood transfusion. This cross-sectional study aimed to assess the trend of HBV prevalence and associated risk factors among a first-time donor population in a low endemic country. STUDY DESIGN AND METHODS Between 2010 and 2018, blood samples were collected from first-time donors presented at donor collection sites of Belgian Red Cross-Flanders. They were tested for hepatitis B surface antigen (HBsAg), hepatitis B core antibodies (anti-HBc), and HBV DNA, HIV and hepatitis virus C (HCV) antibodies and RNA, and syphilis antibodies. RESULTS A total of 211,331 first-time blood donors (43.7% males, median age 25 years) were analyzed. HBsAg prevalence decreased from 0.06% in 2010 to 0.05% in 2018 (p = .004) and this declining trend was accompanied by an increased number of donors in the HBV vaccinated birth cohort (p < .001). HBsAg prevalence was 0.33% in foreign-born donors and 0.02% in Belgian natives (p < .001). Multivariate risk profiling showed that anti-HBc positivity was significantly associated with mainly foreign-born donors (odds ratio [OR] = 9.24) but also with older age (OR = 1.06), male gender (OR = 1.32), year of blood donation (OR = 0.94), and co-infections with HCV (OR = 4.31) or syphilis (OR = 4.91). DISCUSSION The decreasing trend in HBV prevalence could mainly be explained by the introduction of the universal HBV vaccination. Being born in endemic areas was the most important predictor for HBV infection while the co-infections with syphilis suggest unreported sexual risk contacts.
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Affiliation(s)
- Niels De Brier
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
| | - Özgür M Koc
- Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, Genk, Belgium.,Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,Department of Medical Microbiology, School of NUTRIM, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Emmy De Buck
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium.,Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - An Muylaert
- Blood Service, Belgian Red Cross, Mechelen, Belgium
| | - Frederik Nevens
- Department of Gastroenterology and Hepatology, University Hospitals KU Leuven, Leuven, Belgium
| | | | | | - Hans Van Remoortel
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
| | - Geert Robaeys
- Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, Genk, Belgium.,Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,Department of Gastroenterology and Hepatology, University Hospitals KU Leuven, Leuven, Belgium
| | - Veerle Compernolle
- Blood Service, Belgian Red Cross, Mechelen, Belgium.,Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
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