Hepatitis B Virus Blood Screening: Need for Reappraisal of Blood Safety Measures?

Over the past decades, the risk of HBV transfusion-transmission has been steadily reduced through the recruitment of volunteer donors, the selection of donors based on risk-behavior evaluation, the development of increasingly more sensitive hepatitis B antigen (HBsAg) assays, the use of hepatitis B...

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Vydané v:Frontiers in medicine Ročník 5; s. 29
Hlavní autori: Candotti, Daniel, Laperche, Syria
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Switzerland Frontiers media 21.02.2018
Frontiers Media S.A
Predmet:
anti-HBc
blood safety
HBsAg
hepatitis B virus
Life Sciences
Medicine
Microbiology and Parasitology
nucleic acid testing
transfusion
Virology
anti-HBc
residual risk
hepatitis B virus
nucleic acid testing
HBsAg
blood safety
transfusion
ISSN:2296-858X, 2296-858X
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Shrnutí:Over the past decades, the risk of HBV transfusion-transmission has been steadily reduced through the recruitment of volunteer donors, the selection of donors based on risk-behavior evaluation, the development of increasingly more sensitive hepatitis B antigen (HBsAg) assays, the use of hepatitis B core antibody (anti-HBc) screening in some low-endemic countries, and the recent implementation of HBV nucleic acid testing (NAT). Despite this accumulation of blood safety measures, the desirable zero risk goal has yet to be achieved. The residual risk of HBV transfusion-transmission appears associated with the preseroconversion window period and occult HBV infection characterized by the absence of detectable HBsAg and extremely low levels of HBV DNA. Infected donations tested false-negative with serology and/or NAT still persist and derived blood components were shown to transmit the virus, although rarely. Questions regarding the apparent redundancy of some safety measures prompted debates on how to reduce the cost of HBV blood screening. In particular, accumulating data strongly suggests that HBsAg testing may add little, if any HBV risk reduction value when HBV NAT and anti-HBc screening also apply. Absence or minimal acceptable infectious risk needs to be assessed before considering discontinuing HBsAg. Nevertheless, HBsAg remains essential in high-endemic settings where anti-HBc testing cannot be implemented without compromising blood availability. HBV screening strategy should be decided according to local epidemiology, estimate of the infectious risk, and resources.
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PMCID: PMC5826332
Reviewed by: Thierry Burnouf, Taipei Medical University, Taiwan; Anton P. Andonov, National Microbiology Laboratory, Canada
Specialty section: This article was submitted to Hematology, a section of the journal Frontiers in Medicine
Edited by: Christoph Niederhauser, Transfusion Interrégionale CRS SA, Switzerland
ISSN:2296-858X
2296-858X
DOI:10.3389/fmed.2018.00029