High prevalence of anti‐hepatitis <scp>B</scp> core antigen in hepatitis <scp>B</scp> virus–vaccinated <scp>C</scp>hinese blood donors suggests insufficient protection but little threat to the blood supply

Zheng, Xin; Ye, Xianlin; Zeng, Jinfeng; Zhu, Wenxiu; Yang, Baocheng; Li, Chengyao; Allain, Jean‐Pierre

doi:10.1111/trf.12902

Cited by 30 publications

(73 citation statements)

References 26 publications

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“…In 80 initial HBsAg-/DNA+ blood donors, 40% (32/80) were anti-HBs positive and possessed detectable levels of HBV-DNA; of these individuals, eleven, who were followed-up, provided anti-HBs-positive samples, and four had a high viral load. These results were consistent with a study by Zheng et al (26), who showed that of 14 HBV DNA+ vaccinated donors, seven had high levels of anti-HBs. These findings may be explained in part by the findings of Levicnik-Stezinar et al (27), who concluded that low levels of anti-HBs (< 100 IU/L) have limited neutralizing capacity.…”

Section: Discussionsupporting

confidence: 93%

Serological Patterns and Molecular Characterization of Occult Hepatitis B Virus Infection among Blood Donors

Lin

Tang

et al. 2016

Hepat Mon

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BackgroundHepatitis B infections, characterized by the presence of a viral genome without detectable hepatitis B surface antigen (HBsAg; Occult hepatitis B infection [OBI]), have been reported recently.ObjectivesWe performed serological and molecular characterization of OBI among blood donors at Jiangsu province blood center during years 2013 and 2014.MethodsAll donor samples were routinely screened by double enzyme-linked immunosorbent assay (ELISA) for hepatitis C virus (HCV), hepatitis B virus (HBV), human immunodeficiency virus (HIV), Treponema pallidum (TP), and alanine aminotransferase (ALT). Single-reactive, nonreactive, and ALT-elevated samples were pooled or resolved by nucleic acid testing (NAT). Seromarkers were examined in HBsAg-/DNA+ samples. After 1 to 12 months of follow up, seromarkers were screened again to verify OBI samples.ResultsWe studied 157119 samples from blood donors. A total of 154397 ELISA nonreactive donor samples were identified, and HBV DNA was detected in 81 samples; no samples were positive for HIV or HCV RNA. Hepatitis B virus viral loads in most donors were less than 20 - 200 IU/mL. There was only one HBsAg-positive sample. Eighty HBsAg-/DNA+ samples were evaluated further. Of these samples, 85% (68/80) were reactive for anti-HBc and 36.2% (29/800) were reactive for anti-HBc and anti-HBs; 11.3% (9/80) did not have any detectable serological markers. Twenty-nine donors were followed up. One was HBsAg ELISA positive, and of six seronegative donors, all had anti-HBc and anti-HBs, but were negative for DNA. Samples were HBV genotypes B, C and D. Mutations in the S region of HBV DNA included S114T, G119R, P120S, T125M, C139Y, T140I, C147W, T148A, A159V/G, E164D, V168A, and R169C.ConclusionsOverall, we found that OBI was rare, but that the prevalence of OBI was slightly higher in Jiangsu than in other areas of China.

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Section: Discussionsupporting

confidence: 93%

Serological Patterns and Molecular Characterization of Occult Hepatitis B Virus Infection among Blood Donors

Lin

Tang

et al. 2016

Hepat Mon

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“…These repeat donors born between 1992 and 1997 were presumably vaccinated for hepatitis B at 0, 1 and 6 months after birth with recombinant vaccines. All blood donors were voluntary and nonremunerated donors and passed the pre‐donation screening for HBsAg and alanine aminotransferase (ALT) . The pre‐qualified donors donated at mobile collection units or at the blood centre.…”

Section: Methodsmentioning

confidence: 99%

“…The pre‐qualified donors donated at mobile collection units or at the blood centre. Blood samples were routinely screened with 2 different EIAs for HBsAg and antibodies to hepatitis C virus (HCV), human immunodeficiency virus types 1 and 2 (HIV1/2), Treponema pallidum (TP) and ALT . Repeat donor samples were further screened with a multiplex NAT for genomes of HBV, HCV and HIV‐1 (Procleix Ultrio; individual‐donation NAT; Grifols Diagnostic Solutions, San Diego, CA; limit of detection [LOD] HBV DNA 10.4 IU/mL).…”

Section: Methodsmentioning

confidence: 99%

“…PCR amplicons or clones were sequenced by a commercial company (Invitrogen, Guangzhou, China). Reference nucleotide sequences of HBV were retrieved from GenBank, and aligned with sample sequences . Hepatitis B virus DNA genotyping was performed by phylogenetic analysis using a computer program (MEGA7.0; Informer Technologies, Inc., Redwood City, CA) …”

Section: Methodsmentioning

confidence: 99%

“…The presence of anti‐HBc indicates exposure to HBV followed by either persistent carriage of the virus as chronic infection indicated by circulating HBsAg or recovery with clearance of the virus from circulation . Anti‐HBc carriers, with or without anti‐HBs, were reported to have extremely low levels of HBV DNA and recognized as OBI . Several studies showed that seroconversion to anti‐HBc may occur in HBV‐vaccinated individuals suggesting failure of protection when exposed to HBV .…”

Section: Introductionmentioning

confidence: 99%

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Incidence of hepatitis B virus infection in young Chinese blood donors born after mandatory implementation of neonatal hepatitis B vaccination nationwide

Tang

Wang

et al. 2018

Journal of Viral Hepatitis

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This study was carried out to determine the incidence of hepatitis B virus (HBV) infection in the young generation born after mandatory implementation of hepatitis B vaccination since 1992. Repeat blood donors born between 1992 and 1997 were enrolled, who gave blood at least twice during the past 3 years. Donors were tested for HBV infection markers of HBsAg, anti-HBc, anti-HBs and viral DNA by immunoassays (EIAs) and nucleic acid tests (NAT). A total of 14 937 pre-donation screening qualified young repeat donors aged 18-23 years were tested with 9 (0.06%) being HBsAg by EIA and 10 (1:1494) HBV DNA positive by Ultrio NAT (10.4 IU/mL), respectively. HBV DNA was further detected in 1:192 (9/1732) anti-HBc+ repeat donors with Ultrio Plus NAT (3.4 IU/mL). Most cases were identified as occult HBV infection (OBI). Of 14 937 repeat donors, 20.9% were anti-HBc+ positive, while approximately 50% of 12 024 repeat donors were anti-HBs negative or had levels <100 IU/L. HBsAg+ or OBI strains were classified as wild type of genotype B or genotype C. Incident HBV infection in repeat donors was approximately 1:18.5 person-years (1.1%/year) but significantly less frequent in donors with confirmed HBV vaccination (2.4%-3.3%) than those unsure of vaccination status (10.5%; P = .0023). Hepatitis B virus vaccination appears largely protective of HBV infection, but incidence of infections increases in young adults with mostly undetectable or low anti-HBs or occasionally high anti-HBs. A boost of hepatitis B vaccine for adolescents prior to age 18 years may reduce HBV infection, and implementation of more sensitive NAT in blood donation screening may improve HBV safety in blood transfusion.

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Low occurrence of HBsAg but high frequency of transient occult HBV infection in vaccinated and HBIG‐administered infants born to HBsAg positive mothers

Zhou

Allain

et al. 2017

Journal of Medical Virology

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The status of chronic and occult HBV infection (OBI) in neonatal hepatitis B vaccine and immunoglobulin (HBIG) vaccinated infants born to HBsAg+ mothers was investigated at a major hospital in China. Seventy-seven and 15 blood samples were collected in first or second follow-up detection from the vaccinated babies aged 3-36 months born to 43 HBsAg+ or plus 25 HBeAg+ mothers. HBV infection was analyzed between the paired baby and mother by serology and DNA analysis. Among 77 children born to 68 HBsAg+ mothers, 3.9% (3/77) were HBsAg+, and 36.4% (28/77) were HBV DNA+/HBsAg- (OBIs) by a single PCR, respectively. Thirteen of 28 HBV DNA+/HBsAg- samples were conformed by two PCRs or S sequence, which accounted for 16.9% (13/77) of children. Three HBsAg+ and six OBIs were genotyped in consistent with their mother's HBV strains. Of 77 babies' blood samples, anti-HBs reactivity varied slightly according to age groups, while passively transmitted anti-HBc reactivity declined from 100% high reactivity at age 3-5 months to mostly negative at age ≥12 months. Babies with apparent OBI had higher levels of anti-HBc and lower levels of anti-HBs than those without OBI but all eight OBI babies with second follow-up samples became HBV DNA negative beyond 1 year of age. The vaccinated infants born to HBsAg+ mothers presented the low rate of HBsAg occurrence as vaccination failure and high frequency of viral persistence in the form of transient OBIs since no evidence of active HBV infection occurred beyond 1 year of age.

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High prevalence of anti‐hepatitis B core antigen in hepatitis B virus–vaccinated Chinese blood donors suggests insufficient protection but little threat to the blood supply

Cited by 30 publications

References 26 publications

Serological Patterns and Molecular Characterization of Occult Hepatitis B Virus Infection among Blood Donors

Serological Patterns and Molecular Characterization of Occult Hepatitis B Virus Infection among Blood Donors

Incidence of hepatitis B virus infection in young Chinese blood donors born after mandatory implementation of neonatal hepatitis B vaccination nationwide

Low occurrence of HBsAg but high frequency of transient occult HBV infection in vaccinated and HBIG‐administered infants born to HBsAg positive mothers

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