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

Abstract

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.

Occult HBV infection in Chinese blood donors: role of N-glycosylation mutations and amino acid substitutions in S protein transmembrane domains

“…Among the 1,261 blood donors initially screened as HBsAg-/HBV DNA+ in 29 blood centres across China, 918 donors (72.8%) were confirmed as OBI carriers. These OBI donors shared similar male dominance, normal ALT levels, low viral loads, and ages of ≥40 years compared to OBI blood donors from Northern and Eastern Central China and other Asian countries (Table 1) [7,21,22]. HBV genotype C appeared to be slightly over-represented among OBI donors compared to the randomly selected HBsAg+ donor group as suggested by others [8,21–23].…”

Hepatitis B Virus Infection and Biomarkers Correlates of Liver Injury among Healthy Blood Donors in Nigeria

“…All their OBI isolates were males and mostly below 36 years. This also conforms to the reports of Zheng et al [24] which revealed the male to female ratio of OBI as 3 The result of Alanine Aminotransferase (ALT) from this study showed that all OBI blood donors as well as HBV seronegative samples had normal serum ALT concentration This result correlates with the finding of Lin et al [28]. This corroborates with another report from Chinese blood donors with OBI, which reported normal ALT values from their subjects [23].…”

Prevalence and natural course of occult hepatitis B virus infection in residents of 2 communities of Wuwei City, Gansu Province, China

“…It has been reported that the substitution of amino acid 145 is the most frequent mutation in this region . Moreover, amino acid changes at 124,125,126, 127, 129, 130,131,133, 136,137, 138,139, 140, 141, 142,144,145,146 and 147 sites have been described in OBI samples . In the present study, 51 of 80 objects (63.75%) contained the “a” determinant mutation.…”