Su T-H, Chen P-J, Chen T-C, Cheng H-R, Li L, Lin K-S, Kao J-H, Chen D-S, Liu C-J
Department of Internal Medicine, Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.
Transfus Med. 2011 Feb;21(1):33-41. doi: 10.1111/j.1365-3148.2010.01036.x. Epub 2010 Aug 18.
A look-back study was conducted to determine the clinical significance of occult hepatitis B virus (HBV) blood transfusion in an HBV hyperendemic area.
To improve the blood transfusion safety.
Occult HBV is transmissible through blood transfusion in HBV-naÏve recipients. However, its impact on recipients with prevalent HBV infection in HBV hyperendemic areas is unclear.
METHODS/MATERIALS: In 2006, 12 occult HBV blood donors were found from 10 824 repository samples by nucleic acid testing. The 74 corresponding recipients were identified and their pre- and post-transfusion clinical information was gathered, and the living recipients were recalled for follow-up. From the available archival sera, the HBV DNA was examined and sub-genomic sequences between paired donor and recipient were compared using polymerase chain reaction-based assays.
Among the 74 recipients, 18 were still alive and 12 returned to our clinic. From the available serological profiles, 76% of recipients had ongoing or recovered HBV infection before transfusion. Only 24 recipients had available post-transfusion serological profiles and none seroconverted to be hepatitis B surface antigen (HBsAg) positive. Moreover, except for the prior HBsAg carriers, the recipients' HBV DNA levels after transfusion were low (<20 IU/mL). One recipient had identical HBV surface gene sub-genomic sequence (384 nucleotides) to his donor. After transfusion, no recipient developed post-transfusion hepatitis (PTH) and the clinical outcome was good.
In HBV hyperendemic areas, occult hepatitis B transfusion might not lead to HBsAg carriage or PTH. The risk of transfusion-transmitted HBV infection was probably lower than that in non-endemic areas because most recipients had already experienced HBV infection.
开展一项回顾性研究，以确定在乙肝病毒（HBV）高流行地区隐匿性HBV输血的临床意义。
提高输血安全性。
隐匿性HBV可在未感染HBV的受血者中通过输血传播。然而，其对HBV高流行地区HBV感染流行的受血者的影响尚不清楚。
方法/材料：2006年，通过核酸检测在10824份储存样本中发现12名隐匿性HBV献血者。确定了74名相应的受血者，收集了他们输血前后的临床信息，并召回存活的受血者进行随访。从可用的存档血清中，检测HBV DNA，并使用基于聚合酶链反应的检测方法比较配对的献血者和受血者之间的亚基因组序列。
在74名受血者中，18人仍然存活，12人返回我们的诊所。从可用的血清学资料来看，76%的受血者在输血前有持续或已康复的HBV感染。只有24名受血者有输血后的血清学资料，且无人血清转化为乙肝表面抗原（HBsAg）阳性。此外，除了先前的HBsAg携带者外，受血者输血后的HBV DNA水平较低（<20 IU/mL）。一名受血者与其献血者的HBV表面基因亚基因组序列（384个核苷酸）相同。输血后，没有受血者发生输血后肝炎（PTH），临床结局良好。
在HBV高流行地区，隐匿性乙肝输血可能不会导致HBsAg携带或PTH。输血传播HBV感染的风险可能低于非流行地区，因为大多数受血者已经感染过HBV。
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