Hepatitis B and transfusion
Reviewer: Huy Phu Pham, M.D. (see Reviewers page)
Revised: 4 November 2011, last major update October 2011
Copyright: (c) 2007-2011, PathologyOutlines.com, Inc.
● Hepatitis B is a DNA virus, which is transmitted parenterally, sexually, perinatally
● Vaccination of infants and high-risk adults led to a decrease in US incidence from 260,000 to 60,000 new infections/year
● Vaccinated children may be susceptible in endemic areas (J Hepatol 2006;44:39)
● Hepatitis B infection can result in acute infection with subsequent clearance of virus and immunity OR chronic infection with persistent viremia
● Previously, hepatitis B transmission was most serious transfusion-transmitted disease risk, but due to serologic testing, risk of transfusion transmitted HBV is now 1:205,000 among repeat donors, and 1:144,000 among all donors in the US, 1 per 1.3 million units in Australia (Intern Med J 2005;35:592), 1 per 640,000 in France (Transfus Clin Biol 2005;12:239), 1 per 150,000 in Canada (Transfusion 2007;47:316), 1 per 17,500 in Shenzhen, China (Transfusion 2007;47:529), 1 per 1500 in Mexico (Rev Invest Clin 2006;58:101)
● Transfusion transmitted hepatitis B may be over- or under-reported
● To reduce rates even further, vigilance for errors and donor selection may be as important as further testing (Euro Surveill 2005;10:17)
● Value of nucleic acid testing (NAT) is controversial (helpful in high prevalence area - Vox Sang 2006;91:1, Transfusion 2005;45:1247; not helpful in low endemic areas, Mol Diagn Ther 2006;10:77)
● In US, minipool NAT testing does not decrease the window period significantly
● In US, blood banks use sensitive HBsAg and anti-HBc tests
● In most of world, prevalence of anti-HBc is >10%, and use of HBc antibody test may exclude many otherwise healthy donors (J Clin Virol 2006;36:S33)
● Pathogen inactivation has eliminated transmission in US licensed plasma derivatives since 1985; however cannot be used for cellular components (Arch Pathol Lab Med 2007;131:719)
● Only one confirmed transfusion related case in US in 2003; false positive seroconversions may occur due to administration of immunoglobulin (Dtsch Med Wochenschr 2006;131:1325)
● Microarray multiplex assay may be useful to detect Hepatitis B, C and HIV (Biochem Biophys Res Commun 2007;356:1017)
End of Transfusion Medicine > Tranfusion-transmitted disease > Hepatitis B and transfusion
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