Journal
FRONTIERS IN IMMUNOLOGY
Volume 12, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fimmu.2021.699217
Keywords
blood safety; occult hepatitis B infection; nucleic acid testing; anti-HBc; minipool
Categories
Funding
- Nature and Science Fund of Shenzhen and Guangdong [JCYJ20190806112201646, 2021A515010979]
- Shenzhen Key Medical Discipline Construction Fund [SZXK070]
- CAMS Initiative for Innovative Medicine [CAMS-2016-I2M-3-025, CAMS-2017-I2M-BR-15]
- National Key Research and Development Program [2018YFE0107500]
- Science and Technology Partnership Program, Ministry of Science and Technology of China [KY201904011]
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The study analyzed the presence of occult HBV infections in non-resolved blood donations in Chinese Blood Centers. It was found that 53.2% of non-resolved donations were anti-HBc+, and 40.5% of non-resolved pools contained OBIs, posing potential risk for HBV transmission.
Background Most Chinese Blood Centers adopted mini pool (MP) nucleic acid testing (NAT) for HBV screening due to high cost of Individual donation (ID) NAT, and different proportions of MP-reactive but ID-non-reactive donations (MP+/ID-, defined as non-resolved donations) have been observed during daily donor screening process. Some of these non-resolved donations are occult HBV infections (OBIs), which pose potential risk of HBV transmission if they are not deferred. This study is aimed to further analyze these non-resolved donations. Methods The non-resolved plasma samples were further analyzed by serological tests and various HBV DNA amplification assays including quantitative PCR (qPCR) and nested PCR amplifying the basic core and pre-core promoter regions (BCP/PC; 295 base pairs) and HBsAg (S) region (496 base pairs). Molecular characterizations of HBV DNA+ non-resolved samples were determined by sequencing analysis. Results Of 17,226 MPs from 103,356 seronegative blood donations, 98 MPs were detected reactive for HBV. Fifty-six out of these 98 (57.1%) reactive MPs were resolved as HBV DNA+, but the remaining 42 pools (42.9%, 252 donations) were left non-resolved with a high rate (53.2%) of anti-HBc+. Surprisingly, among 42 non-resolved MPs, 17 contained one donation identified as OBIs by alternative NAT assays. Sequence analysis on HBV DNAs extracted from these OBI donations showed some key mutations in the S region that may lead to failure in HBsAg detection and vaccine escape. Conclusion A total of 53.2% of the non-resolved donations were anti-HBc+, and OBIs were identified in 40.5% of these non-resolved pools. Therefore, non-resolved donations with anti-HBc+ might pose potential risk for HBV transmission. Our present analysis indicates that anti-HBc testing in non-resolved donations should be used to identify OBIs in order to further increase blood safety in China.
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