Transfusion-transmitted HBV infection with isolated anti-HBs-positive blood

被引:7
|
作者
Satake, Masahiro [1 ]
Yamagishi, Naoji [1 ]
Tanaka, Ami [1 ]
Goto, Naoko [2 ]
Sakamoto, Tomohiko [3 ]
Yanagino, Yusuke [3 ]
Furuta, Rika A. A. [1 ]
Matsubayashi, Keiji [1 ]
机构
[1] Japanese Red Cross, Cent Blood Inst, 2-1-67 Tatsumi,Koto Ku, Tokyo 1358521, Japan
[2] Japanese Red Cross, Blood Serv Headquarters, Tokyo, Japan
[3] Sakurabashi Watanabe Hosp, Dept Cardiovasc Surg, Osaka, Japan
关键词
anti-HBc; anti-HBs; NAT; OBI; vaccination; HEPATITIS-B-VIRUS; SURFACE-ANTIGEN; DONORS; ANTIBODIES;
D O I
10.1111/trf.17390
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BackgroundHepatitis B virus (HBV)-positive individuals with isolated anti-HBs are found among HBV vaccine recipients and healthy blood donors with no vaccination history. HBV infectivity from blood transfusions derived from such individuals remains unclear. Case PresentationA male patient who received transfusion with blood negative for individual donation-NAT, HBsAg and anti-HBc but weakly positive for anti-HBs developed typical transfusion-transmitted (TT)-HBV with anti-HBc response. The responsible blood donor was a frequent repeat donor showing a marked increase in anti-HBs titer without anti-HBc response 84 days after index donation. Test results for his past donations showed transient viremia with very low viral load and fluctuating low-level anti-HBs. The HBV vaccination history of this donor was unknown. DiscussionAnti-HBs and anti-HBc kinetics of the donor suggest a second antibody response to new HBV challenge, representing a vaccine breakthrough case. On the other hand, transient low-level viremia and fluctuating anti-HBs in the test results of past donations suggested chronic occult HBV infection with isolated anti-HBs. ConclusionWhatever the basic infection state, blood donors with isolated weak anti-HBs may include a small population with a risk of causing TT-HBV. Identifying individuals harboring such TT-HBV risk among individuals positive only for anti-HBs is difficult under current screening strategies. Active surveillance for the occurrence of TT-HBV with blood positive only for anti-HBs is necessary.
引用
收藏
页码:1250 / 1254
页数:5
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