International review of blood donation screening for anti-HBc and occult hepatitis B virus infection.

IF 2.5 3区 医学 Q2 HEMATOLOGY Transfusion Pub Date : 2024-11-01 Epub Date: 2024-10-02 DOI:10.1111/trf.18018
Michael X Fu, Helen M Faddy, Daniel Candotti, Jamel Groves, Paula Saa, Claire Styles, Opeyemi Adesina, Jose Perez Carrillo, Axel Seltsam, Marijke Weber-Schehl, Sheila F O'Brien, Steven J Drews, Nana Benyin Aidoo, Ángel Luis Pajares, Laura Navarro Perez, Xuelian Deng, Thijs van de Laar, Syria Laperche, Riikka Lehtisalo, Soner Yilmaz, Wai-Chiu Tsoi, David Juhl, Christoph Niederhauser, Nahid Chenarsabz, Niamh O'Flaherty, Naoko Goto, Masahiro Satake, Christian Renaud, Antoine Lewin, Marc Cloutier, Salam Sawadogo, Claire Reynolds, Eugene Zhiburt, An Muylaert, Véronique Van Gaever, Michel-Andres Garcia-Otalora, Lisa Jarvis, Marion Vermeulen, Michael Busch, Stuart Blackmore, Ann Jones, Su Brailsford, William L Irving, Monique Andersson, Peter Simmonds, Heli Harvala
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Abstract

Background: Hepatitis B core antibody (anti-HBc) screening has been implemented in many blood establishments to help prevent transmission of hepatitis B virus (HBV), including from donors with occult HBV infection (OBI). We review HBV screening algorithms across blood establishments globally and their potential effectiveness in reducing transmission risk.

Materials and methods: A questionnaire on HBV screening and follow-up strategies was distributed to members of the International Society of Blood Transfusion working party on transfusion-transmitted infectious diseases. Screening data from 2022 were assimilated and analyzed.

Results: A total of 30 unique responses were received from 25 countries. Sixteen respondents screened all donations for anti-HBc, with 14 also screening all donations for HBV DNA. Anti-HBc prevalence was 0.42% in all blood donors and 1.19% in new donors in low-endemic countries; however, only 44% of respondents performed additional anti-HBc testing to exclude false reactivity. 0.68% of anti-HBc positive, HBsAg-negative donors had detectable HBV DNA. Ten respondents did universal HBV DNA screening without anti-HBc, whereas four respondents did not screen for either. Deferral strategies for anti-HBc positive donors were highly variable. One transfusion-transmission from an anti-HBc negative donor was reported.

Discussion: Anti-HBc screening identifies donors with OBI but also results in the unnecessary deferral of a significant number of donors with resolved HBV infection and donors with false-reactive anti-HBc results. Whilst confirmation of anti-HBc results could be improved to reduce donor deferral, transmission risks associated with anti-HBc negative OBI donors must be considered. In high-endemic areas, highly sensitive HBV DNA testing is required to identify infectious donors.

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抗-HBc 和隐性乙型肝炎病毒感染献血筛查的国际回顾。
背景:许多血液机构已开始实施乙肝核心抗体(抗-HBc)筛查,以帮助预防乙肝病毒(HBV)传播,包括来自隐性 HBV 感染(OBI)献血者的传播。我们回顾了全球血液机构的 HBV 筛查算法及其在降低传播风险方面的潜在效果:我们向国际输血学会输血传播传染病工作组的成员发放了一份关于 HBV 筛查和随访策略的调查问卷。对 2022 年的筛查数据进行了归纳和分析:结果:共收到来自 25 个国家的 30 份回复。其中 16 个国家对所有捐献者进行了抗-HBc 筛查,14 个国家还对所有捐献者进行了 HBV DNA 筛查。在低流行率国家,所有献血者中抗 HBc 感染率为 0.42%,新献血者中为 1.19%;然而,只有 44% 的受访者进行了额外的抗 HBc 检测以排除假反应。在抗-HBc 阳性、HBsAg 阴性的献血者中,有 0.68% 检测到了 HBV DNA。有 10 个受访者在不检测抗-HBc 的情况下进行了普遍的 HBV DNA 筛查,而有 4 个受访者则没有进行这两项筛查。抗-HBc 阳性供体的暂缓策略差异很大。有报告称,抗-HBc 阴性供体造成了一次输血传播:讨论:抗-HBc 筛查可识别患有 OBI 的捐献者,但也会导致大量已解除 HBV 感染的捐献者和抗-HBc 结果呈假反应的捐献者被不必要地推诿。虽然可以改进抗-HBc 结果的确认,以减少供体推迟,但必须考虑与抗-HBc 阴性 OBI 供体相关的传播风险。在高端流行区,需要进行高灵敏度的 HBV DNA 检测,以确定感染性供体。
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来源期刊
Transfusion
Transfusion 医学-血液学
CiteScore
4.70
自引率
20.70%
发文量
426
审稿时长
1 months
期刊介绍: TRANSFUSION is the foremost publication in the world for new information regarding transfusion medicine. Written by and for members of AABB and other health-care workers, TRANSFUSION reports on the latest technical advances, discusses opposing viewpoints regarding controversial issues, and presents key conference proceedings. In addition to blood banking and transfusion medicine topics, TRANSFUSION presents submissions concerning patient blood management, tissue transplantation and hematopoietic, cellular, and gene therapies.
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