International review of blood donation screening for anti-HBc and occult hepatitis B virus infection

the Virology subgroup of the ISBT WP-TTID

doi:10.1111/trf.18018

International review of blood donation screening for anti-HBc and occult hepatitis B virus infection

the Virology subgroup of the ISBT WP-TTID

Research output: Contribution to journal › Article › peer-review

5 Citations (Scopus)

Abstract

Background: Hepatitis B core antibody (anti-HBc) screening has been implemented in many blood establishments to help prevent transmission of hepatitis B virus (HBV), including from donors with occult HBV infection (OBI). We review HBV screening algorithms across blood establishments globally and their potential effectiveness in reducing transmission risk. Materials and Methods: A questionnaire on HBV screening and follow-up strategies was distributed to members of the International Society of Blood Transfusion working party on transfusion-transmitted infectious diseases. Screening data from 2022 were assimilated and analyzed. Results: A total of 30 unique responses were received from 25 countries. Sixteen respondents screened all donations for anti-HBc, with 14 also screening all donations for HBV DNA. Anti-HBc prevalence was 0.42% in all blood donors and 1.19% in new donors in low-endemic countries; however, only 44% of respondents performed additional anti-HBc testing to exclude false reactivity. 0.68% of anti-HBc positive, HBsAg-negative donors had detectable HBV DNA. Ten respondents did universal HBV DNA screening without anti-HBc, whereas four respondents did not screen for either. Deferral strategies for anti-HBc positive donors were highly variable. One transfusion-transmission from an anti-HBc negative donor was reported. Discussion: Anti-HBc screening identifies donors with OBI but also results in the unnecessary deferral of a significant number of donors with resolved HBV infection and donors with false-reactive anti-HBc results. Whilst confirmation of anti-HBc results could be improved to reduce donor deferral, transmission risks associated with anti-HBc negative OBI donors must be considered. In high-endemic areas, highly sensitive HBV DNA testing is required to identify infectious donors.

Original language	English
Pages (from-to)	2144-2156
Number of pages	13
Journal	Transfusion
Volume	64
Issue number	11
DOIs	https://doi.org/10.1111/trf.18018
Publication status	Published - Nov 2024
Externally published	Yes

Bibliographical note

Publisher Copyright:
© 2024 The Author(s). Transfusion published by Wiley Periodicals LLC on behalf of AABB.

Keywords

HBV screening
NAT
anti-HBc testing
blood transfusion
safety

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1111/trf.18018

Cite this

@article{04b56ef90fcb4ebe9bf48c038f664a08,

title = "International review of blood donation screening for anti-HBc and occult hepatitis B virus infection",

abstract = "Background: Hepatitis B core antibody (anti-HBc) screening has been implemented in many blood establishments to help prevent transmission of hepatitis B virus (HBV), including from donors with occult HBV infection (OBI). We review HBV screening algorithms across blood establishments globally and their potential effectiveness in reducing transmission risk. Materials and Methods: A questionnaire on HBV screening and follow-up strategies was distributed to members of the International Society of Blood Transfusion working party on transfusion-transmitted infectious diseases. Screening data from 2022 were assimilated and analyzed. Results: A total of 30 unique responses were received from 25 countries. Sixteen respondents screened all donations for anti-HBc, with 14 also screening all donations for HBV DNA. Anti-HBc prevalence was 0.42% in all blood donors and 1.19% in new donors in low-endemic countries; however, only 44% of respondents performed additional anti-HBc testing to exclude false reactivity. 0.68% of anti-HBc positive, HBsAg-negative donors had detectable HBV DNA. Ten respondents did universal HBV DNA screening without anti-HBc, whereas four respondents did not screen for either. Deferral strategies for anti-HBc positive donors were highly variable. One transfusion-transmission from an anti-HBc negative donor was reported. Discussion: Anti-HBc screening identifies donors with OBI but also results in the unnecessary deferral of a significant number of donors with resolved HBV infection and donors with false-reactive anti-HBc results. Whilst confirmation of anti-HBc results could be improved to reduce donor deferral, transmission risks associated with anti-HBc negative OBI donors must be considered. In high-endemic areas, highly sensitive HBV DNA testing is required to identify infectious donors.",

keywords = "HBV screening, NAT, anti-HBc testing, blood transfusion, safety",

author = "{the Virology subgroup of the ISBT WP-TTID} and Fu, {Michael X.} and Faddy, {Helen M.} and Daniel Candotti and Jamel Groves and Paula Saa and Claire Styles and Opeyemi Adesina and Carrillo, {Jose Perez} and Axel Seltsam and Marijke Weber-Schehl and O'Brien, {Sheila F.} and Drews, {Steven J.} and Aidoo, {Nana Benyin} and Pajares, {{\'A}ngel Luis} and Perez, {Laura Navarro} and Xuelian Deng and {van de Laar}, Thijs and Syria Laperche and Riikka Lehtisalo and Soner Yilmaz and Tsoi, {Wai Chiu} and David Juhl and Christoph Niederhauser and Nahid Chenarsabz and Niamh O'Flaherty and Naoko Goto and Masahiro Satake and Christian Renaud and Antoine Lewin and Marc Cloutier and Salam Sawadogo and Claire Reynolds and Eugene Zhiburt and An Muylaert and {Van Gaever}, V{\'e}ronique and Garcia-Otalora, {Michel Andres} and Lisa Jarvis and Marion Vermeulen and Michael Busch and Stuart Blackmore and Ann Jones and Su Brailsford and Irving, {William L.} and Monique Andersson and Peter Simmonds and Heli Harvala",

note = "Publisher Copyright: {\textcopyright} 2024 The Author(s). Transfusion published by Wiley Periodicals LLC on behalf of AABB.",

year = "2024",

month = nov,

doi = "10.1111/trf.18018",

language = "English",

volume = "64",

pages = "2144--2156",

journal = "Transfusion",

issn = "0041-1132",

publisher = "John Wiley and Sons Inc.",

number = "11",

}

TY - JOUR

T1 - International review of blood donation screening for anti-HBc and occult hepatitis B virus infection

AU - the Virology subgroup of the ISBT WP-TTID

AU - Fu, Michael X.

AU - Faddy, Helen M.

AU - Candotti, Daniel

AU - Groves, Jamel

AU - Saa, Paula

AU - Styles, Claire

AU - Adesina, Opeyemi

AU - Carrillo, Jose Perez

AU - Seltsam, Axel

AU - Weber-Schehl, Marijke

AU - O'Brien, Sheila F.

AU - Drews, Steven J.

AU - Aidoo, Nana Benyin

AU - Pajares, Ángel Luis

AU - Perez, Laura Navarro

AU - Deng, Xuelian

AU - van de Laar, Thijs

AU - Laperche, Syria

AU - Lehtisalo, Riikka

AU - Yilmaz, Soner

AU - Tsoi, Wai Chiu

AU - Juhl, David

AU - Niederhauser, Christoph

AU - Chenarsabz, Nahid

AU - O'Flaherty, Niamh

AU - Goto, Naoko

AU - Satake, Masahiro

AU - Renaud, Christian

AU - Lewin, Antoine

AU - Cloutier, Marc

AU - Sawadogo, Salam

AU - Reynolds, Claire

AU - Zhiburt, Eugene

AU - Muylaert, An

AU - Van Gaever, Véronique

AU - Garcia-Otalora, Michel Andres

AU - Jarvis, Lisa

AU - Vermeulen, Marion

AU - Busch, Michael

AU - Blackmore, Stuart

AU - Jones, Ann

AU - Brailsford, Su

AU - Irving, William L.

AU - Andersson, Monique

AU - Simmonds, Peter

AU - Harvala, Heli

PY - 2024/11

Y1 - 2024/11

N2 - Background: Hepatitis B core antibody (anti-HBc) screening has been implemented in many blood establishments to help prevent transmission of hepatitis B virus (HBV), including from donors with occult HBV infection (OBI). We review HBV screening algorithms across blood establishments globally and their potential effectiveness in reducing transmission risk. Materials and Methods: A questionnaire on HBV screening and follow-up strategies was distributed to members of the International Society of Blood Transfusion working party on transfusion-transmitted infectious diseases. Screening data from 2022 were assimilated and analyzed. Results: A total of 30 unique responses were received from 25 countries. Sixteen respondents screened all donations for anti-HBc, with 14 also screening all donations for HBV DNA. Anti-HBc prevalence was 0.42% in all blood donors and 1.19% in new donors in low-endemic countries; however, only 44% of respondents performed additional anti-HBc testing to exclude false reactivity. 0.68% of anti-HBc positive, HBsAg-negative donors had detectable HBV DNA. Ten respondents did universal HBV DNA screening without anti-HBc, whereas four respondents did not screen for either. Deferral strategies for anti-HBc positive donors were highly variable. One transfusion-transmission from an anti-HBc negative donor was reported. Discussion: Anti-HBc screening identifies donors with OBI but also results in the unnecessary deferral of a significant number of donors with resolved HBV infection and donors with false-reactive anti-HBc results. Whilst confirmation of anti-HBc results could be improved to reduce donor deferral, transmission risks associated with anti-HBc negative OBI donors must be considered. In high-endemic areas, highly sensitive HBV DNA testing is required to identify infectious donors.

AB - Background: Hepatitis B core antibody (anti-HBc) screening has been implemented in many blood establishments to help prevent transmission of hepatitis B virus (HBV), including from donors with occult HBV infection (OBI). We review HBV screening algorithms across blood establishments globally and their potential effectiveness in reducing transmission risk. Materials and Methods: A questionnaire on HBV screening and follow-up strategies was distributed to members of the International Society of Blood Transfusion working party on transfusion-transmitted infectious diseases. Screening data from 2022 were assimilated and analyzed. Results: A total of 30 unique responses were received from 25 countries. Sixteen respondents screened all donations for anti-HBc, with 14 also screening all donations for HBV DNA. Anti-HBc prevalence was 0.42% in all blood donors and 1.19% in new donors in low-endemic countries; however, only 44% of respondents performed additional anti-HBc testing to exclude false reactivity. 0.68% of anti-HBc positive, HBsAg-negative donors had detectable HBV DNA. Ten respondents did universal HBV DNA screening without anti-HBc, whereas four respondents did not screen for either. Deferral strategies for anti-HBc positive donors were highly variable. One transfusion-transmission from an anti-HBc negative donor was reported. Discussion: Anti-HBc screening identifies donors with OBI but also results in the unnecessary deferral of a significant number of donors with resolved HBV infection and donors with false-reactive anti-HBc results. Whilst confirmation of anti-HBc results could be improved to reduce donor deferral, transmission risks associated with anti-HBc negative OBI donors must be considered. In high-endemic areas, highly sensitive HBV DNA testing is required to identify infectious donors.

KW - HBV screening

KW - NAT

KW - anti-HBc testing

KW - blood transfusion

KW - safety

UR - http://www.scopus.com/inward/record.url?scp=85205563302&partnerID=8YFLogxK

U2 - 10.1111/trf.18018

DO - 10.1111/trf.18018

M3 - Article

C2 - 39359112

AN - SCOPUS:85205563302

SN - 0041-1132

VL - 64

SP - 2144

EP - 2156

JO - Transfusion

JF - Transfusion

IS - 11

ER -

International review of blood donation screening for anti-HBc and occult hepatitis B virus infection

Abstract

Bibliographical note

Keywords

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this