Occult hepatitis B infections among blood donors in Lao PDR

Vox Sang. 2014 Jan;106(1):31-7. doi: 10.1111/vox.12073. Epub 2013 Aug 12.

Abstract

Background and objectives: In Lao People's Democratic Republic, hepatitis B virus is highly endemic. However, blood donations are only screened for HBsAg, leaving a risk of transmission by HBsAg-negative occult infected donors. Here, we characterized first-time blood donors to assess prevalence of hepatitis B virus infections and occult infected donors.

Materials and methods: Sera were screened for HBsAg, HBeAg and anti-HBs, anti-HBc and anti-HBe antibodies. Occult HBV infections (OBIs) were assessed in HBsAg-negative sera by PCR, and sera of HBsAg positive and occult infected donors were phylogenetically characterized.

Results: 9·6% of the donors were HBsAg positive, and 45.5% were positive for at least one of the hepatitis B virus serum markers. More than 40% HBsAg carriers were HBeAg positive, with HBeAg seroconversion occurring around 30 years of age. Furthermore, 10·9% of HBsAg-negative, anti-HBc and/or anti-HBs-positive donors were occult infected with hepatitis B virus. Thus, at least 3·9% of blood donations would potentially be unsafe, but hepatitis B virus DNA copy numbers greatly varied between donors.

Conclusion: In Lao People's Democratic Republic, a sizable proportion of HBsAg-negative and anti-HBc antibody-positive blood donations are potentially DNA positive and infective for hepatitis B.

Keywords: chronic hepatitis B infection; hepatitis B virus; occult hepatitis B infection; seroclearance; serological markers.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Biomarkers / blood
  • Blood Donors*
  • DNA, Viral / blood
  • DNA, Viral / genetics
  • DNA, Viral / immunology
  • Female
  • Hepatitis B / epidemiology*
  • Hepatitis B / immunology
  • Hepatitis B / transmission
  • Hepatitis B Antibodies / blood
  • Hepatitis B Antibodies / genetics
  • Hepatitis B Antibodies / immunology
  • Hepatitis B Core Antigens / blood
  • Hepatitis B Core Antigens / immunology
  • Hepatitis B Surface Antigens / blood
  • Hepatitis B Surface Antigens / immunology
  • Hepatitis B virus / genetics
  • Hepatitis B virus / immunology
  • Humans
  • Laos / epidemiology
  • Male
  • Middle Aged
  • Polymerase Chain Reaction
  • Prevalence
  • Young Adult

Substances

  • Biomarkers
  • DNA, Viral
  • Hepatitis B Antibodies
  • Hepatitis B Core Antigens
  • Hepatitis B Surface Antigens