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Molecular characterization of occult hepatitis B cases in Greek blood donors

✍ Scribed by Antigoni Katsoulidou; Dimitrios Paraskevis; Emmanouil Magiorkinis; Zissis Moschidis; Catherine Haida; Eleni Hatzitheodorou; Agoritsa Varaklioti; Anastasia Karafoulidou; Maria Hatzitaki; Lilian Kavallierou; Athanasia Mouzaki; Evaggelia Andrioti; Chrysanthi Veneti; Athanasia Kaperoni; Eleftheria Zervou; Constantina Politis; Angelos Hatzakis

Publisher
John Wiley and Sons
Year
2009
Tongue
English
Weight
145 KB
Volume
81
Category
Article
ISSN
0146-6615

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✦ Synopsis

Abstract

The use of sensitive nucleic acid testing for hepatitis B virus in blood donors revealed a number of HBV DNA(+) cases among HBsAg(−) donors, a status known as occult HBV infection. The purpose of this study was the serological and molecular characterization of occult HBV infection in Greek blood donors. A prospective study was undertaken in order to identify occult HBV infection cases in blood donors. As part of the routine screening of blood donations in Greece, blood units were screened individually by a multiplex HIV‐1/HCV/HBV nucleic acid assay. Initially reactive samples were retested with discriminatory assays. HBV DNA(+)/HBsAg(−) samples were tested further for HBV serological markers and HBV DNA was quantified by real‐time PCR. Molecular characterization was performed by sequencing the envelope and polymerase genes of HBV. Preliminary screening revealed 21 occult cases with the following patterns: anti‐HBc only: 7 donors, anti‐HBc/anti‐HBs: 7 donors, anti‐HBc/anti‐HBe: 5 donors, anti‐HBc/anti‐HBs/anti‐HBe: 2 donors. In all cases, the HBV DNA load was <351 IU/ml. Sequencing was successful in 10 donors (classified within genotype D) revealing several amino acid substitutions related to diagnostic escape and antiviral resistance. HBsAg diagnostic failure and low viral replication in occult HBV infection carriers could possibly be attributed to multiple changes in envelope and polymerase regions, respectively. J. Med. Virol. 81:815–825, 2009. © 2009 Wiley‐Liss, Inc.

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