Occult Hepatitis B Virus (HBV) Infections among Organ and Tissue Donors: Lessons Learned from "Real Time" Testing
Mendez National Institute of Transplantation, Los Angeles
University of Southern California, Los Angeles
Meeting: 2013 American Transplant Congress
Abstract number: 347
Background: Currently Hepatitis B surface Antigen (HBsAg) and Hepatitis B core Antibody (anti-HBc) screening is used to reduce organ/tissue-transmitted HBV. Although this serologic testing algorithm reduces transplant-transmitted HBV infections, some HBsAg-negative donors can still transmit HBV to transplant recipients. This is likely due to HBsAg seronegative window period donations or Occult HBV Infection (OHI). OHI is one characterized by a low level of HBV-DNA remaining detectable in serum and liver tissue in some patients who have cleared HBsAg from either acute self-limited or chronic HBV infection, or even after a successful anti-HBV treatment. Therefore to further reduce the risk of transfusion-related HBV, in December, 2011 our laboratory began screening all organ and tissue donors using TMA-based multiplexing NAT assay (ULTRIO, Gen-Probe/Novartis, San Diego, CA) capable of detecting HBV DNA, HCV and HIV RNA.
Aim: To share our data obtained during NAT + serology screening for HBV of organ and tissue donors in the Western United States during real-time testing.
Methods: Between 12/2011 and 11/2012 we tested 4216 donors for HBV DNA, HBsAg (Bio-Rad) and anti-HBc (Ortho Diagnostics).
| Total Tested | HBsAg (-) | HBsAg (+) | HBV DNA (+) |
|---|---|---|---|
| 4216 | 4179 | 37 | 19 |
Results: We summarized HBV NAT + serology data in table 1. Additionally, 10 donors were HBV DNA reactive but upon request from the client, serology was not performed. There were 265 donors reactive for “anti-HBc+ only” and negative for HBV DNA. There were no donors reactive for HBV DNA only but 5 donors were HBsAg non-reactive, anti-HBc reactive and HBV DNA positive (OHI donors, table 2).
| HBsAg (-) | HBsAg (+) | |
|---|---|---|
| Anti-HBc (-) | 0 | 0 |
| Anti-HBc (+) | 5 | 14 |
Conclusions: Our data is a first attempt to determine the prevalence of OHI among organ donors in the US. We identified 5 donors (1.2%) fulfilling criteria of occult or latent HBV infection. Our findings are in agreement with published data for blood donors, showing that 1.6% of negative HBsAg and positive anti-HBc blood samples have HBV DNA and may transmit HBV. Considering our results screening organ donors for HBV DNA may substantially reduce chances of HBV transmission from transplanted organs and tissues.
To cite this abstract in AMA style:
Chinchilla-Reyes C, Taguibao R, Nowicki M. Occult Hepatitis B Virus (HBV) Infections among Organ and Tissue Donors: Lessons Learned from "Real Time" Testing [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/occult-hepatitis-b-virus-hbv-infections-among-organ-and-tissue-donors-lessons-learned-from-real-time-testing/. Accessed May 17, 2025.« Back to 2013 American Transplant Congress